ArticleCatheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions2026
Impact of Strut Thickness for Patients Treated With Percutaneous Revascularization for Coronary Bifurcations: Insights From the BIFURCAT-ULTRA Registry.
Article in Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Impact of Strut Thickness for Patients Treated With Percutaneous Revascularization for Coronary Bifurcations: Insights From the BIFURCAT-ULTRA Registry.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2026Article
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28 authors.
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Abstract
backgroundWhether strut thickness influences clinical outcomes after percutaneous coronary intervention (PCI) for bifurcation lesions remains debated.
aimsTo compare the safety and efficacy of ultrathin (< 70 µm) drug-eluting stents (DES) with thicker DES in coronary bifurcations.
methodsWe pooled patient-level data from the ULTRA and BIFURCAT registries. Stents were classified as thick (≥ 100 µm), thin (70-100 µm), or ultrathin (< 70 µm). The primary endpoint was target-lesion revascularization (TLR). Inverse probability of treatment weighting (IPTW) balanced baseline characteristics overall and within procedural subgroups (provisional vs. planned two-stent strategy).
resultsAmong 6753 patients (median follow-up 800 days, IQR 400-900), 514 (8%) received thick, 5139 (76%) thin, and 1100 (16%) ultrathin stents. Crude TLR rates were 3.3%, 2.8%, and 1.1%, respectively (p = 0.001). After IPTW adjustment, ultrathin DES significantly reduced TLR compared with thick DES (HR 0.38, 95% CI = 0.16-0.89, p = 0.03) and with thin DES (HR 0.41, 95% CI 0.21-0.81, p = 0.01). In provisional-stenting cases, TLR risk did not differ across groups (HR: 0.53 vs. thick, p = 0.27; HR: 0.49 vs. thin, p = 0.07). Conversely, in planned two-stent procedures ultrathin DES resulted associated with TLR reduction versus thick DES (HR: 0.21, 95% CI 0.04-0.93, p = 0.04), with a nonsignificant trend for thin DES (HR: 0.31, p = 0.07).
conclusionsIn contemporary bifurcation PCI, ultrathin DES are associated with a clinically and statistically significant reduction in repeat revascularization compared with thicker-strut platforms, a benefit driven predominantly by lesions treated with an upfront two-stent approach.
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