Department of Cardiology and Clinical Research Center, National Hospital Organization Kyushu Medical Center, 1-8-1, Jigyohama, Chuo, Fukuoka, 810-8563, Japan.
Department of Cardiovascular Medicine, Toyohashi Heart Center, Toyohashi, Japan.
Cardiovasc Interv Ther. 2022 Jan;37(1):89-100. doi: 10.1007/s12928-020-00742-7. Epub 2021 Jan 16.
The coronary bifurcation intervention varies among countries due to the differences in assessment of lesion severity and treatment devices. We sought to clarify the difference in basic strategy between South Korea and Japan. A total of 19 and 32 experts from Korean (KBC) and Japanese Bifurcation Clubs (JBC), respectively, answered a survey questionnaire concerning their usual procedure of coronary bifurcation intervention. JBC experts performed less two-stent deployment in the left main (LM) bifurcation compared to KBC experts (JBC vs. KBC: median, 1-10% vs. 21-30%, p < 0.0001) instead of higher performance of side branch dilation after cross-over stenting in both LM (60% vs. 21%, p = 0.001) and non-LM bifurcations (30% vs. 5%, p = 0.037). KBC experts more frequently performed proximal optimization technique (POT) in non-LM bifurcation (41-60% vs. 81-99%, p = 0.028) and re-POT in both LM (1-20% vs. 81-99%, p = 0.017) and non-LM bifurcations (1-20% vs. 81-99%, p = 0.0003). JBC experts more frequently performed imaging-guided percutaneous coronary intervention, whereas KBC experts more often used a pressure wire to assess side branch ischemia. JBC experts used a rotablator more aggressively under the guidance of optical coherence tomography. We clarified the difference in the basic strategy of coronary bifurcation intervention between South Korea and Japan for better understanding the trend in each country.
由于对病变严重程度和治疗器械的评估不同，冠状动脉分叉介入在各国之间存在差异。我们旨在阐明韩国和日本之间基本策略的差异。共有 19 名和 32 名分别来自韩国分叉俱乐部（KBC）和日本分叉俱乐部（JBC）的专家回答了一项关于他们在冠状动脉分叉介入中的常规操作的调查问卷。与 KBC 专家相比，JBC 专家在左主干（LM）分叉处进行双支架植入术的比例较低（JBC 与 KBC：中位数，1-10% vs. 21-30%，p<0.0001），而在交叉支架置入后进行分支扩张的比例较高LM（60% vs. 21%，p=0.001）和非 LM 分叉（30% vs. 5%，p=0.037）。KBC 专家更频繁地在非 LM 分叉处进行近端优化技术（POT）（41-60% vs. 81-99%，p=0.028）和 LM（1-20% vs. 81-99%，p=0.017）和非 LM 分叉处的再 POT（1-20% vs. 81-99%，p=0.0003）。JBC 专家更频繁地进行影像学指导的经皮冠状动脉介入治疗，而 KBC 专家更常使用压力导丝来评估侧支缺血。在光学相干断层扫描的指导下，JBC 专家更积极地使用旋磨术。我们阐明了韩国和日本冠状动脉分叉介入基本策略的差异，以便更好地了解两国的趋势。
