Cargando…

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

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 pati...

Descripción completa

Detalles Bibliográficos
Autores principales: Ki, You-Jeong, Jung, Ji Hyun, Han, Jung-Kyu, Hong, Sukkeun, Cho, Jang Hyun, Gwon, Hyeon-Cheol, Lee, Sung Yun, Rhew, Jay Young, Chae, Jei Keon, Chae, In-Ho, Yang, Han-Mo, Park, Kyung Woo, Kang, Hyun-Jae, Koo, Bon-Kwon, Kim, Hyo-Soo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7374237/
https://www.ncbi.nlm.nih.gov/pubmed/32733170
http://dx.doi.org/10.1155/2020/2475930
_version_ 1783561653905784832
author Ki, You-Jeong
Jung, Ji Hyun
Han, Jung-Kyu
Hong, Sukkeun
Cho, Jang Hyun
Gwon, Hyeon-Cheol
Lee, Sung Yun
Rhew, Jay Young
Chae, Jei Keon
Chae, In-Ho
Yang, Han-Mo
Park, Kyung Woo
Kang, Hyun-Jae
Koo, Bon-Kwon
Kim, Hyo-Soo
author_facet Ki, You-Jeong
Jung, Ji Hyun
Han, Jung-Kyu
Hong, Sukkeun
Cho, Jang Hyun
Gwon, Hyeon-Cheol
Lee, Sung Yun
Rhew, Jay Young
Chae, Jei Keon
Chae, In-Ho
Yang, Han-Mo
Park, Kyung Woo
Kang, Hyun-Jae
Koo, Bon-Kwon
Kim, Hyo-Soo
author_sort Ki, You-Jeong
collection PubMed
description 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% 1(st) generation drug-eluting stent (DES), 37% 2(nd) 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.
format Online
Article
Text
id pubmed-7374237
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Hindawi
record_format MEDLINE/PubMed
spelling pubmed-73742372020-07-29 Clinical Implications of Bifurcation Angles in Left Main Bifurcation Intervention Using a Two-Stent Technique Ki, You-Jeong Jung, Ji Hyun Han, Jung-Kyu Hong, Sukkeun Cho, Jang Hyun Gwon, Hyeon-Cheol Lee, Sung Yun Rhew, Jay Young Chae, Jei Keon Chae, In-Ho Yang, Han-Mo Park, Kyung Woo Kang, Hyun-Jae Koo, Bon-Kwon Kim, Hyo-Soo J Interv Cardiol Research Article 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% 1(st) generation drug-eluting stent (DES), 37% 2(nd) 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. Hindawi 2020-07-11 /pmc/articles/PMC7374237/ /pubmed/32733170 http://dx.doi.org/10.1155/2020/2475930 Text en Copyright © 2020 You-Jeong Ki et al. http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Ki, You-Jeong
Jung, Ji Hyun
Han, Jung-Kyu
Hong, Sukkeun
Cho, Jang Hyun
Gwon, Hyeon-Cheol
Lee, Sung Yun
Rhew, Jay Young
Chae, Jei Keon
Chae, In-Ho
Yang, Han-Mo
Park, Kyung Woo
Kang, Hyun-Jae
Koo, Bon-Kwon
Kim, Hyo-Soo
Clinical Implications of Bifurcation Angles in Left Main Bifurcation Intervention Using a Two-Stent Technique
title Clinical Implications of Bifurcation Angles in Left Main Bifurcation Intervention Using a Two-Stent Technique
title_full Clinical Implications of Bifurcation Angles in Left Main Bifurcation Intervention Using a Two-Stent Technique
title_fullStr Clinical Implications of Bifurcation Angles in Left Main Bifurcation Intervention Using a Two-Stent Technique
title_full_unstemmed Clinical Implications of Bifurcation Angles in Left Main Bifurcation Intervention Using a Two-Stent Technique
title_short Clinical Implications of Bifurcation Angles in Left Main Bifurcation Intervention Using a Two-Stent Technique
title_sort clinical implications of bifurcation angles in left main bifurcation intervention using a two-stent technique
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7374237/
https://www.ncbi.nlm.nih.gov/pubmed/32733170
http://dx.doi.org/10.1155/2020/2475930
work_keys_str_mv AT kiyoujeong clinicalimplicationsofbifurcationanglesinleftmainbifurcationinterventionusingatwostenttechnique
AT jungjihyun clinicalimplicationsofbifurcationanglesinleftmainbifurcationinterventionusingatwostenttechnique
AT hanjungkyu clinicalimplicationsofbifurcationanglesinleftmainbifurcationinterventionusingatwostenttechnique
AT hongsukkeun clinicalimplicationsofbifurcationanglesinleftmainbifurcationinterventionusingatwostenttechnique
AT chojanghyun clinicalimplicationsofbifurcationanglesinleftmainbifurcationinterventionusingatwostenttechnique
AT gwonhyeoncheol clinicalimplicationsofbifurcationanglesinleftmainbifurcationinterventionusingatwostenttechnique
AT leesungyun clinicalimplicationsofbifurcationanglesinleftmainbifurcationinterventionusingatwostenttechnique
AT rhewjayyoung clinicalimplicationsofbifurcationanglesinleftmainbifurcationinterventionusingatwostenttechnique
AT chaejeikeon clinicalimplicationsofbifurcationanglesinleftmainbifurcationinterventionusingatwostenttechnique
AT chaeinho clinicalimplicationsofbifurcationanglesinleftmainbifurcationinterventionusingatwostenttechnique
AT yanghanmo clinicalimplicationsofbifurcationanglesinleftmainbifurcationinterventionusingatwostenttechnique
AT parkkyungwoo clinicalimplicationsofbifurcationanglesinleftmainbifurcationinterventionusingatwostenttechnique
AT kanghyunjae clinicalimplicationsofbifurcationanglesinleftmainbifurcationinterventionusingatwostenttechnique
AT koobonkwon clinicalimplicationsofbifurcationanglesinleftmainbifurcationinterventionusingatwostenttechnique
AT kimhyosoo clinicalimplicationsofbifurcationanglesinleftmainbifurcationinterventionusingatwostenttechnique