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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...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi
2020
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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 |
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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 |
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