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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.

journal_name

J Interv Cardiol

journal_title

Journal of interventional cardiology

authors

Ki YJ,Jung JH,Han JK,Hong S,Cho JH,Gwon HC,Lee SY,Rhew JY,Chae JK,Chae IH,Yang HM,Park KW,Kang HJ,Koo BK,Kim HS

doi

10.1155/2020/2475930

subject

Has Abstract

pub_date

2020-07-11 00:00:00

pages

2475930

eissn

0896-4327

issn

1540-8183

journal_volume

2020

pub_type

杂志文章

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