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Long-term outcomes of simple crossover stenting from the left main to the left anterior descending coronary artery

  • Lee, Ho-Myung (Department of Internal Medicine, Keimyung University School of Medicine) ;
  • Nam, Chang-Wook (Department of Internal Medicine, Keimyung University School of Medicine) ;
  • Cho, Yun-Kyeong (Department of Internal Medicine, Keimyung University School of Medicine) ;
  • Yoon, Hyuck-Jun (Department of Internal Medicine, Keimyung University School of Medicine) ;
  • Park, Hyoung-Seob (Department of Internal Medicine, Keimyung University School of Medicine) ;
  • Kim, Hyungseop (Department of Internal Medicine, Keimyung University School of Medicine) ;
  • Chung, In-Sung (Department of Occupational and Environmental Medicine, Keimyung University School of Medicine) ;
  • Heo, Yun-Seok (Department of Biomedical Engineering, Keimyung University School of Medicine) ;
  • Hur, Seung-Ho (Department of Internal Medicine, Keimyung University School of Medicine) ;
  • Kim, Yoon-Nyun (Department of Internal Medicine, Keimyung University School of Medicine) ;
  • Kim, Kwon-Bae (Department of Internal Medicine, Keimyung University School of Medicine)
  • 투고 : 2014.02.27
  • 심사 : 2014.05.01
  • 발행 : 2014.09.01

초록

Background/Aims: Although complex bifurcation stenting in patients with non-left main (LM) bifurcation lesions has not yielded better clinical outcomes than simpler procedures, the utility of complex bifurcation stenting to treat LM bifurcation lesions has not yet been adequately explored. Methods: In the present study, patients who underwent LM-to-left anterior descending (LAD) coronary artery simple crossover stenting to treat significant de novo distal LM or ostial LAD disease, in the absence of angiographically significant ostial left circumflex (LCX) coronary artery disease, were consecutively enrolled. The frequencies of 3-year major adverse cardiovascular events (MACEs; cardiac death, myocardial infarction, and target lesion revascularization), were analyzed. Results: Of 105 eligible consecutive patients, only 12 (11.4%) required additional procedures to treat ostial LCX disease after main vessel stenting. The mean percentage diameter of ostial LCX stenosis increased from $22.5%{\pm}15.2%$ to $32.3%{\pm}16.3%$ (p < 0.001) after LM-to-LAD simple crossover stenting. The 3-year incidence of MACEs was 9.7% (cardiac death 2.2%; myocardial infarction 2.2%; target lesion revascularization 8.6%), and that of stent thrombosis 1.1%. Of seven cases (7.5%) requiring restenosis, pure ostial LCX-related repeat revascularization was required by only two. Conclusions: Simple crossover LM-to-LAD stenting without opening of a strut on the LCX ostium was associated with acceptable long-term clinical outcomes.

키워드

과제정보

연구 과제 주관 기관 : Keimyung University

참고문헌

  1. Sharma SK, Mares AM, Kini AS. Coronary bifurcation lesions. Minerva Cardioangiol 2009;57:667-682.
  2. Colombo A, Moses JW, Morice MC, et al. Randomized study to evaluate sirolimus-eluting stents implanted at coronary bifurcation lesions. Circulation 2004;109:1244-1249. https://doi.org/10.1161/01.CIR.0000118474.71662.E3
  3. Song YB, Hahn JY, Choi SH, et al. Sirolimus- versus paclitaxel-eluting stents for the treatment of coronary bifurcations results: from the COBIS (Coronary Bifurcation Stenting) Registry. J Am Coll Cardiol 2010;55:1743-1750. https://doi.org/10.1016/j.jacc.2010.02.008
  4. Athappan G, Ponniah T, Jeyaseelan L. True coronary bifurcation lesions: meta-analysis and review of literature. J Cardiovasc Med (Hagerstown) 2010;11:103-110. https://doi.org/10.2459/JCM.0b013e32832ffc85
  5. Niemela M, Kervinen K, Erglis A, et al. Randomized comparison of final kissing balloon dilatation versus no final kissing balloon dilatation in patients with coronary bifurcation lesions treated with main vessel stenting: the Nordic- Baltic Bifurcation Study III. Circulation 2011;123:79-86. https://doi.org/10.1161/CIRCULATIONAHA.110.966879
  6. Gwon HC, Choi SH, Song YB, et al. Long-term clinical results and predictors of adverse outcomes after drug-eluting stent implantation for bifurcation lesions in a real-world practice: the COBIS (Coronary Bifurcation Stenting) registry. Circ J 2010;74:2322-2328. https://doi.org/10.1253/circj.CJ-10-0352
  7. Gwon HC, Hahn JY, Koo BK, et al. Final kissing ballooning and long-term clinical outcomes in coronary bifurcation lesions treated with 1-stent technique: results from the COBIS registry. Heart 2012;98:225-231. https://doi.org/10.1136/heartjnl-2011-300322
  8. Nam CW, Hur SH, Koo BK, et al. Fractional flow reserve versus angiography in left circumflex ostial intervention after left main crossover stenting. Korean Circ J 2011;41:304-307. https://doi.org/10.4070/kcj.2011.41.6.304
  9. Griswold KS, Servoss TJ, Leonard KE, et al. Connections to primary medical care after psychiatric crisis. J Am Board Fam Pract 2005;18:166-172. https://doi.org/10.3122/jabfm.18.3.166
  10. Austen WG, Edwards JE, Frye RL, et al. A reporting system on patients evaluated for coronary artery disease: report of the Ad Hoc Committee for Grading of Coronary Artery Disease, Council on Cardiovascular Surgery, American Heart Association. Circulation 1975;51(4 Suppl):5-40. https://doi.org/10.1161/01.CIR.51.4.5
  11. Koo BK, Park KW, Kang HJ, et al. Physiological evaluation of the provisional side-branch intervention strategy for bifurcation lesions using fractional flow reserve. Eur Heart J 2008;29:726-732. https://doi.org/10.1093/eurheartj/ehn045
  12. Steigen TK, Maeng M, Wiseth R, et al. Randomized study on simple versus complex stenting of coronary artery bifurcation lesions: the Nordic bifurcation study. Circulation 2006;114:1955-1961. https://doi.org/10.1161/CIRCULATIONAHA.106.664920
  13. Hildick-Smith D, de Belder AJ, Cooter N, et al. Randomized trial of simple versus complex drug-eluting stenting for bifurcation lesions: the British Bifurcation Coronary Study: old, new, and evolving strategies. Circulation 2010;121:1235-1243. https://doi.org/10.1161/CIRCULATIONAHA.109.888297
  14. Latib A, Colombo A, Sangiorgi GM. Bifurcation stenting: current strategies and new devices. Heart 2009;95:495-504. https://doi.org/10.1136/hrt.2008.150391
  15. Koo BK, Kang HJ, Youn TJ, et al. Physiologic assessment of jailed side branch lesions using fractional flow reserve. J Am Coll Cardiol 2005;46:633-637. https://doi.org/10.1016/j.jacc.2005.04.054
  16. Koo BK, De Bruyne B. FFR in bifurcation stenting: what have we learned? EuroIntervention 2010;6 Suppl J:J94-J98. https://doi.org/10.4244/EIJV6SUPJA15
  17. Song YB, Hahn JY, Yang JH, et al. Differential prognostic impact of treatment strategy among patients with left main versus non-left main bifurcation lesions undergoing percutaneous coronary intervention: results from the COBIS (Coronary Bifurcation Stenting) Registry II. JACC Cardiovasc Interv 2014;7:255-263. https://doi.org/10.1016/j.jcin.2013.11.009
  18. Kim YH, Park SW, Hong MK, et al. Comparison of simple and complex stenting techniques in the treatment of unprotected left main coronary artery bifurcation stenosis. Am J Cardiol 2006;97:1597-1601. https://doi.org/10.1016/j.amjcard.2005.12.051
  19. Lim MJ, Kern MJ. Utility of coronary physiologic hemodynamics for bifurcation, aorto-ostial, and ostial branch stenoses to guide treatment decisions. Catheter Cardiovasc Interv 2005;65:461-468. https://doi.org/10.1002/ccd.20435

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