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Comparison of simple versus complex stenting in patients with true distal left main bifurcation lesions

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Author(s)
Cheol Hyun LeeJung‐Min AhnDo‐Yoon KangMinkyu HanHanbit ParkPil Hyung LeeSeung‐Whan LeeSeong‐Wook ParkDuk‐Woo ParkSeung‐Jung Park
Keimyung Author(s)
Lee, Cheol Hyun
Department
Dept. of Internal Medicine (내과학)
Journal Title
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
Issued Date
2021
Volume
97
Issue
5
Keyword
bifurcation lesionscoronary artery diseasedrug-eluting stents
Abstract
Introduction:
Distal left main (LM) bifurcation disease is one of the most challenging lesion subsets for percutaneous coronary intervention (PCI) and optimal stenting strategy for such complex lesions is still debated. This study aimed to compare clinical outcomes following single versus dual stenting for true distal LM bifurcation lesions.

Methods:
Patients with true distal LM bifurcation lesions (type 1,1,1 or 0,1,1: both left anterior descending and circumflex artery >2.5 mm diameter) receiving PCI with drug‐eluting stents (DES) from two large clinical registries were evaluated. The primary outcome was target‐lesion failure (TLF), defined as a composite of cardiac death, target‐vessel myocardial infarction (MI), or target‐lesion revascularization (TLR). Outcomes were compared with the use of propensity scores and inverse probability‐weighting adjustment to reduce treatment selection bias.

Results:
Among 1,002 patients undergoing true distal LM PCI, 440 (43.9%) and 562 (56.1%) were treated with single and dual stents, respectively. The TLF rates at 3 year was 20.3% in the single‐stent group and 24.1% in the dual‐stenting group (log‐rank p = 0.18). The adjusted risk for TLF did not differ significantly between two groups (hazard ratio [HR] with dual‐stent vs. single‐stent: 1.27, 95% confidence interval [CI]: 0.95–1.71). The adjusted risks for death, MI, repeat revascularization, or stent thrombosis were also similar between the single‐ and dual‐stenting groups.

Conclusions:
In patients undergoing PCI for true distal LM disease, single‐ and dual‐stent strategies showed a similar adjusted risk of TLF at 3 years. Our findings should be confirmed or refuted through large, randomized clinical trials.
Keimyung Author(s)(Kor)
이철현
Publisher
School of Medicine (의과대학)
Citation
Cheol Hyun Lee et al. (2021). Comparison of simple versus complex stenting in patients with true distal left main bifurcation lesions. Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions, 97(5), 776–785. doi: 10.1002/ccd.29219
Type
Article
ISSN
1522-726X
Source
https://onlinelibrary.wiley.com/doi/10.1002/ccd.29219
DOI
10.1002/ccd.29219
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43008
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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