Acute procedural and six-month clinical outcome in patients treated with a dedicated bifurcation stent for left main stem disease: The TRYTON LM multicentre registry

Michael Magro, Chrysafios Girasis, Antonio L. Bartorelli, Giuseppe Tarantini, Filippo Russo, Daniela Trabattoni, Gianpiero D'Amico, Mario Galli, Alfredo Gómez Juame, Manuel De Sousa Almeida, Cihan Simsek, David Foley, Jeroen Sonck, Maciej Lesiak, Peter Kayaert, Patrick W. Serruys, Robert Jan Van Geuns

Research output: Contribution to journalArticle

Abstract

Aims: Tryton side branch (SB) reverse culotte stenting has been employed for the treatment of left main (LM) stem bifurcations in patients at high risk for bypass surgery. The aim of this study was to assess acute angiographic results and six-month clinical outcome after implantation of the Tryton stent in the LM. Methods and results: We studied 52 consecutive patients with LM disease treated in nine European centres. Angiographic and clinical data analysis was performed centrally. Fifty-one of 52 patients (age 68±11 yrs, 75% male, 42% unstable angina, SYNTAX score 20±8) were successfully treated with the Tryton stent. Medina class was 1,1,1 in 33 (63%), 1,0,1 in 7 (13%), 1,1,0 in 3 (6%), 0,1,1 in 8 (4%) and 0,0,1 in 1 (2%). The Tryton stent on a stepped balloon (diameter 3.5-2.5 mm) was used in 41/51 (80%) of cases. The mean main vessel stent diameter was 3.4±0.4 mm with an everolimus-eluting stent employed in 30/51 (59%) of cases. Final kissing balloon dilatation was performed in 48/51 (94%). Acute gain was 1.52±0.86 mm in the LM and 0.92±0.47 mm in the SB. The angiographic success rate was 100%; the procedural success rate reached 94%. Periprocedural MI occurred in three patients. At six-month follow-up, the TLR rate was 12%, MI 10% and cardiac death 2%. The hierarchical MACE rate at six months was 22%. No cases of definite stent thrombosis occurred. Conclusions: The use of the Tryton stent for treatment of LM bifurcation disease in combination with a conventional drug-eluting stent is feasible and achieves an optimal angiographic result. Safety of the procedure and six-month outcome are acceptable in this high-risk lesion PCI. Further safety and efficacy studies with long-term outcome assessment of this strategy are warranted.

Original languageEnglish
Pages (from-to)1259-1269
Number of pages11
JournalEuroIntervention
Volume8
Issue number11
Publication statusPublished - Mar 2013

Keywords

  • 3-D quantitative coronary angiography
  • Dedicated bifurcation stents
  • Left main stem bifurcation
  • Six-month MACE
  • Sprocedural success

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Magro, M., Girasis, C., Bartorelli, A. L., Tarantini, G., Russo, F., Trabattoni, D., D'Amico, G., Galli, M., Juame, A. G., Almeida, M. D. S., Simsek, C., Foley, D., Sonck, J., Lesiak, M., Kayaert, P., Serruys, P. W., & Van Geuns, R. J. (2013). Acute procedural and six-month clinical outcome in patients treated with a dedicated bifurcation stent for left main stem disease: The TRYTON LM multicentre registry. EuroIntervention, 8(11), 1259-1269.