Bifurcation Lesions in ST-Segment Elevation Myocardial Infarction (STEMI): The Double Stent Technique: Is it Still a Risk Factor for Stent Thrombosis (ST)?

Background and Objectives: STEMI is associated with a pro-thrombotic milieu and as such treatment of bifurcation lesions is aimed towards the provisional strategy, avoiding 2-stent approach a priori. We sought to compare one vs. 2-stent approach as treatment options for STEMI involving bifurcation lesions.

Methods: We analyzed 204 consecutive patients presenting with STEMI involving bifurcation lesions who underwent primary PCI at our center between 2002-2017. Patients were allocated into 2 groups based on the strategy used, e.g. one vs. two-stent approach. We compared their demographic and angiographic characteristics and the effects of strategy on clinical outcomes after one year.

Results: Patients in both groups were of similar age and gender. There was no difference in the location of bifurcation lesions and in the LV ejection fraction (EF).

*LAD- Left anterior descending, LCx- Left circumflex, RCA- Right coronary artery

Outcomes were similar in both strategies at all time points (Table II).

Conclusions: Our study shows that in case of need, the 2-stent strategy for bifurcation lesions during STEMI is not associated with increased risk for subsequent adverse angiographic or clinical events compared to a single provisional stenting technique.