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Clinical Implications of Bifurcation Angles in Left Main Bifurcation Intervention Using a Two-Stent Technique.


ABSTRACT: Objectives:The aim of this study was to assess the clinical impact of 3 bifurcation angles in left main (LM) bifurcation treated with the 2-stent technique. Background:Data are limited regarding the impact of bifurcation angles after LM percutaneous coronary intervention (PCI). Methods:Using patient-level 4 multicenter registries in Korea, 462 patients undergoing LM bifurcation PCI with the 2-stent technique were identified (181 crush, 167 T-stenting; 63% 1st generation drug-eluting stent (DES), 37% 2nd generation DES). Three bifurcation angles, between the LM and left anterior descending (LAD), the LM and left circumflex (LCX), and the LAD and LCX, were measured. The primary outcome was target lesion failure (TLF), a composite of cardiac death, myocardial infarction, and target lesion revascularization (TLR). Results:In patients treated with the crush technique, the best cutoff value (BCV) to predict TLF was 152° of the LM-LAD angle. In the crush group, a significantly higher TLF rate, mostly driven by TLR, was observed in the LM-LAD angle ?152° group compared with the <152° group (35.7% vs. 14.6%; adjusted hazard ratio 3.476; 95% confidence interval 1.612-7.492). An LM-LAD angle ?152° was an independent predictor of TLF. In the T-stenting, no bifurcation angle affected the clinical outcomes. Conclusions:In LM bifurcation PCI using the 2-stent technique, wide LM-LAD angle (?152°) was associated with a greater risk of TLF in the crush, whereas none of the bifurcation angles affected T-stenting outcomes.

SUBMITTER: Ki YJ 

PROVIDER: S-EPMC7374237 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Clinical Implications of Bifurcation Angles in Left Main Bifurcation Intervention Using a Two-Stent Technique.

Ki You-Jeong YJ   Jung Ji Hyun JH   Han Jung-Kyu JK   Hong Sukkeun S   Cho Jang Hyun JH   Gwon Hyeon-Cheol HC   Lee Sung Yun SY   Rhew Jay Young JY   Chae Jei Keon JK   Chae In-Ho IH   Yang Han-Mo HM   Park Kyung Woo KW   Kang Hyun-Jae HJ   Koo Bon-Kwon BK   Kim Hyo-Soo HS  

Journal of interventional cardiology 20200711


<h4>Objectives</h4>The aim of this study was to assess the clinical impact of 3 bifurcation angles in left main (LM) bifurcation treated with the 2-stent technique.<h4>Background</h4>Data are limited regarding the impact of bifurcation angles after LM percutaneous coronary intervention (PCI).<h4>Methods</h4>Using patient-level 4 multicenter registries in Korea, 462 patients undergoing LM bifurcation PCI with the 2-stent technique were identified (181 crush, 167 T-stenting; 63% 1<sup>st</sup> gen  ...[more]

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