Liaqat Ali, Naeem Asghar, Muhammad Nazim.
Clinical and Angiographic Predictors of Major Side Branch Occlusion after Main Vessel Stenting in Coronary Bifurcation Lesions.
Ann Pak Inst Med Sci Jan ;12(3):151-5.

Objective: The objective of the study was to document the frequency and predicting factors of this PCI related complication in our population. Study Design: It is prospective observational study. Place and Duration: This study was conducted at Khatam un Nabeyeen Heart Center, Sargodha from October 2015 to March 2016. Materials and Methods: Total 50 patients who fulfill the inclusion and exclusion criteria were recruited in this study. Patients admitted for PCI using one stent or provisional two stent strategy) of bifurcation lesions were enrolled in this study. A base line ECG and echocardiography was performed. Regarding risk factors for CAD, history of hypertension, diabetes mellitus, family H/O ischemic heart disease and hyperlipidemia was noted. In all patients before PCI, routine blood investigations were obtained. With Quantitative coronary angiography (QCA) diameters and stenosis percentage of main branch as well as side branch was measures. Results: The mean age of patients was 50.2 ± 12.8 (range 35-70). 35(70%) patients were male and 15(30%) were female. 18(36%) were hypertensive, diabetes was present in 20(40). 21(42%) of the patients had type D bifurcation lesion followed by type B lesion patients 13(26%). 36(72%) patients had stenosis >80% and in 34(68%) patients disease segment was 20 mm in length. Side branch compromise (SBC) was observed in 22(44%) patients. Most of the patient who got SBC during intervention were suffering from type D lesion 14(63.6%). With SBC 10(45.5%) had complaint of chest pain, 2(9.09%) got Non-Q wave MI. There was no incidence of mortality in patient having SBC. Conclusions: Coronary arteries with severe (> 80% stenosis) and diffuse (lesion length > 20 mm) lesions are mostly associated with side branch occlusion during PCI. LVEF, Bifurcation angle, TIMI flow grade of SB before PCI major predictors for SBC. Similarly elderly, male and diabetic are more prone to side branch occlusion.

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