Long-term outcome after the V stenting technique in de novo bifurcation lesions using drug-eluting stents

Aims: To report long-term outcome data on the V technique using drug-eluting stents. Methods and results: From April 2002 to December 2006, 31 consecutive patients were successfully treated with V stenting of a de novo bifurcation lesion. The technique involves the deployment of two stents in the two branches of a bifurcation, the proximal edges of the stents just touching one another. Patients exclusively received either sirolimus- (10), paclitaxel- (20) or biolimus-eluting (one) stents. On average, 1.5±0.8 stents with a total length of 26.6±17.2 mm and 1.1±0.4 stents with a total length of 18.3±7.6 mm were deployed in the distal main vessel and side branch respectively. Mean duration of follow-up was 853±553 days. Within 30 days, three patients died; two other patients had definite stent thrombosis involving the V stents, both requiring re-PCI. Beyond 30 days and within one year, there was one death and three cases of target vessel revascularisation, including one target lesion revascularisation. There were a further three deaths (one cardiac) beyond one year. Eleven patients (35.5%) had angiographic follow-up, exhibiting a binary restenosis rate of 9.1% at 203±33 days. Conclusions: In this real-world cohort, late clinical events stand in accord with studies on competitive techniques, but early outcome was less encouraging, probably due to the baseline risks.