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...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2020-01-01
|
| Series: | Journal of Interventional Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2020/2475930 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832550544756965376 |
|---|---|
| author | You-Jeong Ki Ji Hyun Jung Jung-Kyu Han Sukkeun Hong Jang Hyun Cho Hyeon-Cheol Gwon Sung Yun Lee Jay Young Rhew Jei Keon Chae In-Ho Chae Han-Mo Yang Kyung Woo Park Hyun-Jae Kang Bon-Kwon Koo Hyo-Soo Kim |
| author_facet | You-Jeong Ki Ji Hyun Jung Jung-Kyu Han Sukkeun Hong Jang Hyun Cho Hyeon-Cheol Gwon Sung Yun Lee Jay Young Rhew Jei Keon Chae In-Ho Chae Han-Mo Yang Kyung Woo Park Hyun-Jae Kang Bon-Kwon Koo Hyo-Soo Kim |
| author_sort | You-Jeong Ki |
| collection | DOAJ |
| 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% 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. |
| format | Article |
| id | doaj-art-36b5ce937dd54347b7f458ad827226cc |
| institution | Kabale University |
| issn | 0896-4327 1540-8183 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Interventional Cardiology |
| spelling | doaj-art-36b5ce937dd54347b7f458ad827226cc2025-02-03T06:06:29ZengWileyJournal of Interventional Cardiology0896-43271540-81832020-01-01202010.1155/2020/24759302475930Clinical Implications of Bifurcation Angles in Left Main Bifurcation Intervention Using a Two-Stent TechniqueYou-Jeong Ki0Ji Hyun Jung1Jung-Kyu Han2Sukkeun Hong3Jang Hyun Cho4Hyeon-Cheol Gwon5Sung Yun Lee6Jay Young Rhew7Jei Keon Chae8In-Ho Chae9Han-Mo Yang10Kyung Woo Park11Hyun-Jae Kang12Bon-Kwon Koo13Hyo-Soo Kim14Cardiovascular Center, Seoul National University Hospital, Seoul 03080, Republic of KoreaCardiovascular Center, Seoul National University Hospital, Seoul 03080, Republic of KoreaCardiovascular Center, Seoul National University Hospital, Seoul 03080, Republic of KoreaDivision of Cardiology, Department of Internal Medicine, Sejong General Hospital, Bucheon 14754, Republic of KoreaDepartment of Internal Medicine, St. Carollo Hospital, Sunchon 57931, Republic of KoreaHeart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of KoreaInje University Ilsan Paik Hospital, Goyang 10380, Republic of KoreaDivision of Cardiology, Department of Internal Medicine, Presbyterian Medical Center, Jeonju 54987, Republic of KoreaChonbuk National University Hospital, Jeonju 54907, Republic of KoreaSeoul National University Bundang Hospital, Sungnam 13620, Republic of KoreaCardiovascular Center, Seoul National University Hospital, Seoul 03080, Republic of KoreaCardiovascular Center, Seoul National University Hospital, Seoul 03080, Republic of KoreaCardiovascular Center, Seoul National University Hospital, Seoul 03080, Republic of KoreaCardiovascular Center, Seoul National University Hospital, Seoul 03080, Republic of KoreaCardiovascular Center, Seoul National University Hospital, Seoul 03080, Republic of KoreaObjectives. 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.http://dx.doi.org/10.1155/2020/2475930 |
| spellingShingle | You-Jeong Ki Ji Hyun Jung Jung-Kyu Han Sukkeun Hong Jang Hyun Cho Hyeon-Cheol Gwon Sung Yun Lee Jay Young Rhew Jei Keon Chae In-Ho Chae Han-Mo Yang Kyung Woo Park Hyun-Jae Kang Bon-Kwon Koo Hyo-Soo Kim Clinical Implications of Bifurcation Angles in Left Main Bifurcation Intervention Using a Two-Stent Technique Journal of Interventional Cardiology |
| 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 |
| url | http://dx.doi.org/10.1155/2020/2475930 |
| work_keys_str_mv | AT youjeongki clinicalimplicationsofbifurcationanglesinleftmainbifurcationinterventionusingatwostenttechnique AT jihyunjung clinicalimplicationsofbifurcationanglesinleftmainbifurcationinterventionusingatwostenttechnique AT jungkyuhan clinicalimplicationsofbifurcationanglesinleftmainbifurcationinterventionusingatwostenttechnique AT sukkeunhong clinicalimplicationsofbifurcationanglesinleftmainbifurcationinterventionusingatwostenttechnique AT janghyuncho clinicalimplicationsofbifurcationanglesinleftmainbifurcationinterventionusingatwostenttechnique AT hyeoncheolgwon clinicalimplicationsofbifurcationanglesinleftmainbifurcationinterventionusingatwostenttechnique AT sungyunlee clinicalimplicationsofbifurcationanglesinleftmainbifurcationinterventionusingatwostenttechnique AT jayyoungrhew clinicalimplicationsofbifurcationanglesinleftmainbifurcationinterventionusingatwostenttechnique AT jeikeonchae clinicalimplicationsofbifurcationanglesinleftmainbifurcationinterventionusingatwostenttechnique AT inhochae clinicalimplicationsofbifurcationanglesinleftmainbifurcationinterventionusingatwostenttechnique AT hanmoyang clinicalimplicationsofbifurcationanglesinleftmainbifurcationinterventionusingatwostenttechnique AT kyungwoopark clinicalimplicationsofbifurcationanglesinleftmainbifurcationinterventionusingatwostenttechnique AT hyunjaekang clinicalimplicationsofbifurcationanglesinleftmainbifurcationinterventionusingatwostenttechnique AT bonkwonkoo clinicalimplicationsofbifurcationanglesinleftmainbifurcationinterventionusingatwostenttechnique AT hyosookim clinicalimplicationsofbifurcationanglesinleftmainbifurcationinterventionusingatwostenttechnique |