†These authors contributed equally.
Academic Editors: George Dangas, Christian Hengstenberg and Gianluca Rigatelli
Background: A simple stenting strategy with provisional
side-branch (SB) stenting or crossover stenting has been recommended as the
default approach for most coronary bifurcation lesions (CBLs). The proximal
optimization technique (POT) and POT-associated techniques (POTAs) were
introduced to optimize the ostium of SB. However, these techniques are unable to
remove the jailed struts or completely diminish vessel damage. In this study we
developed a novel branch ostial optimization technique (BOOT) and assessed its
efficacy and safety by a propensity score matching comparison (PSM) with
POT-associated techniques (POTA). Methods: From June 2016 to March 2018,
a total of 203 consecutive patients with true CBLs were treated with BOOT (50
patients) or POTA stenting (153 patients). We performed PSM to correct for
confounders from clinical and lesion characteristics. The primary endpoint was
cumulative major adverse cardiac events (MACE) at 12 months including cardiac
death, non-fatal myocardial infarction, and target vessel/lesion
revascularization (TVR/TLR) or target vessel/lesion thrombosis (ST).
Results: After PSM, there were 43 patients in each group.
Follow-up coronary angiography was performed in 77 (89.5%) patients. At 12
months, the angiographic restenosis rate was significantly different between the
BOOT group and the POTA group after PSM (proximal main branch: 20.01