In order to bring you the best possible user experience, this site uses Javascript. If you are seeing this message, it is likely that the Javascript option in your browser is disabled. For optimal viewing of this site, please ensure that Javascript is enabled for your browser.
Did you know that your browser is out of date? To get the best experience using our website we recommend that you upgrade to a newer version. Learn more.

We use cookies to optimise the design of this website and make continuous improvement. By continuing your visit, you consent to the use of cookies. Learn more

Trial results of stenting for coronary bifurcation

ESC Congress News 2016 - Rome, Italy

Invasive and Interventional Cardiology, Cardiovascular Surgery


Coronary bifurcations – a type of coronary artery narrowing - are best treated with Culotte stenting as opposed to T-and-protrusion (TAP) stenting, when there is a need for side-branch stenting, according to the BBKII trial presented yesterday. The trial, published simultaneously in the European Heart Journal, represents the first ever head-to-head comparison of the two most commonly used techniques in side branch stenting with anatomy considered suitable for both techniques.

‘Interventional cardiologists can now use Culotte stenting with more confidence knowing that this technique is associated with a very low angiographic restenosis rate and lower rate of TLR as compared with TAP stenting,’ said study presenter Miroslaw Ferenc, from the University Heart Center, Freiburg, Bad Krozingen, Germany, ‘even though it is slightly more challenging and requires appropriate training,’ In coronary bifurcation lesions side branch stenting is necessary in 5-36% of patients for optimal results.

In the Bifurcations Bad Krozingen (BBKII) study, 300 patients with stable or unstable angina were deemed amenable to both stenting techniques and were randomised to either TAP stenting (n=150) or Culotte stenting (n=150).

Results at nine months showed that the primary endpoint of maximal in-stent diameter stenosis of the bifurcation lesion (assessed by follow-up quantitative coronary) was 27% for Culotte stenting versus 20% for TAP stenting.The difference in the primary endpoint was driven almost entirely by differences in the side branch, where the mean percent diameter stenosis was 16% in the Culotte arm versus 22% in the TAP stenting arm.

Other important differences favouring Culotte stenting included a highly significant difference in binary in-stent restenosis at the bifurcation lesion, which occurred in 6.5% of the Culotte arm and 17% of the TAP arm as well as the target lesion rate of  bifurcation lesion revascularization rate at one year, which occurred in 6% of the Culotte arm versus 12 % of the TAP arm.

‘Given the clear results of this trial together with the same trend for hard clinical endpoints, Culotte stenting has now to be seen as the preferred approach for coronary bifurcations, when stenting of the site branch is needed,’ concluded Ferenc.

 

Click here to read other scientific highlights in the full edition of the Congress news.

Notes to editor

To access all the scientific resources from the sessions during the congress, visit ESC Congress 365.  

About the European Society of Cardiology

The European Society of Cardiology brings together health care professionals from more than 120 countries, working to advance cardiovascular medicine and help people lead longer, healthier lives.

About ESC Congress 2016

ESC Congress is the world’s largest gathering of cardiovascular professionals contributing to global awareness of the latest clinical trials and breakthrough discoveries. ESC Congress 2016 takes place 27 to 31 August at the Fiera di Roma in Rome, Italy. The full scientific programme is here.