Impact of Final Kissing Balloon and of Imaging on Patients Treated on Unprotected Left Main Coronary Artery With Thin-Strut Stents (From the RAIN-CARDIOGROUP VII Study)

Fabrizio D'Ascenzo, Pierluigi Omedè, Ovidio De Filippo, Enrico Cerrato, Michele Autelli, Daniela Trabattoni, Nicola Ryan, Giuseppe Venuti, Saverio Muscoli, Andrea Montabone, Wojciech Wojakowski, Andrea Rognoni, Gerard Helft, Diego Gallo, Radoslaw Parma, Leonardo De Luca, Filippo Figini, Satoru Mitomo, Giacomo Boccuzzi, Alessio MattesiniWojciech Wańha, Grzegorz Smolka, Zenon Huczek, Bernardo Cortese, Imad Sheiban, Javier Escaned, Carloalberto Biolè, Federico Conrotto, Christian Templin, Giorgio Quadri, Cristina Rolfo, Davide Capodanno, Alaide Chieffo, Ivan Nuñez-Gil, Umberto Morbiducci, Mario Iannaccone, Sebastiano Gili, Carlo di Mario, Claudio Moretti, Maurizio D'Amico, Ferdinando Varbella, Francesco Romeo, Thomas F. Lüscher

Research output: Contribution to journalArticle

Abstract

Few data are available about the impact on outcomes of procedural strategies for percutaneous coronary intervention with thin-struts stents on unprotected left main (ULM): 792 patients with an ULM stenosis treated with percutaneous coronary intervention with thin-strut stents were enrolled in the present multicenter registry. Target lesion revascularization (TLR) was the primary end point. MACE (a composite of all-cause death, myocardial infarction, TLR, and stent thrombosis) and its single components, along with target vessel revascularization were the secondary end points. Subgroup analyses were performed according to complex versus noncomplex bifurcation lesions. After 16 months, 5.5% of patients experienced a TLR. At multivariate analysis, provisional stenting (odds ratio [OR] 0.46: 0.85 to 0.23, p = 0.006), use of imaging (OR 0.45: 0.23 to 0.98, p = 0.003) and final kissing balloon (FKB) (OR 0.41: 0.83 to 0.21, p = 0.001) reduced risk of TLR. FKB reduced risk of overall TLR only for 2 stents-strategy (6.2% vs 32.4%, p <0.05), but not for provisional strategy (3.8% vs 3.7%, p = 0.67). Intracoronary imaging reduced risk of overall TLR both for provisional (2.2% vs 5.4%) and for 2-stents strategy (7.3% vs 14.1% p <0.05 for both, all confidence interval 95%). In conclusion, TLR for ULM patients treated with thin-strut stents is infrequent. Provisional stenting was noninferior compared with 2-stents apart from complex lesions. Benefit from intracoronary imaging is consistent for different strategies, whereas that from FKB persists only for 2-stents.

Original languageEnglish
Pages (from-to)1610-1619
Number of pages10
JournalAmerican Journal of Cardiology
Volume123
Issue number10
DOIs
Publication statusPublished - May 15 2019

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    D'Ascenzo, F., Omedè, P., De Filippo, O., Cerrato, E., Autelli, M., Trabattoni, D., Ryan, N., Venuti, G., Muscoli, S., Montabone, A., Wojakowski, W., Rognoni, A., Helft, G., Gallo, D., Parma, R., De Luca, L., Figini, F., Mitomo, S., Boccuzzi, G., ... Lüscher, T. F. (2019). Impact of Final Kissing Balloon and of Imaging on Patients Treated on Unprotected Left Main Coronary Artery With Thin-Strut Stents (From the RAIN-CARDIOGROUP VII Study). American Journal of Cardiology, 123(10), 1610-1619. https://doi.org/10.1016/j.amjcard.2019.02.013