Provisional vs. two-stent technique for unprotected left main coronary artery disease after ten years follow up: A propensity matched analysis

Fabrizio D'Ascenzo, Mario Iannaccone, Francesca Giordana, Alaide Chieffo, Stephen O. Connor, L. Christian Napp, Sujay Subash Chandran, José María De La Torre Hernández, Shao Liang Chen, Ferdinando Varbella, Pierluigi Omedè, Salma Taha, Emanuele Meliga, Hiroyoshi Kawamoto, Antonio Montefusco, Mervyn Chong, Philippe Garot, Lin Sin, Valeria Gasparetto, Mohamed AbdirashidEnrico Cerrato, Giuseppe Biondi-Zoccai, Fiorenzo Gaita, Javier Escaned, David Hiddick Smith, Thierry Lefèvre, Antonio Colombo, Imad Sheiban, Claudio Moretti

Research output: Contribution to journalArticlepeer-review


Aims: There is uncertainty on which stenting approach confers the best long-term outlook for unprotected left main (ULM) bifurcation disease. Methods and results: This is a non-randomized, retrospective study including all consecutive patients with 50% stenosis of the left main involving at least 1 of the arteries stemming from the left main treated with drug-eluting stents (DES) in 9 European centers between 2002 and 2004. Patients were divided into two groups: those treated with provisional stentings vs. those treated with two stent strategy. The outcomes of interest were 10-year rates of target lesion revascularization (TLR), major adverse cardiac events (MACE), and their components (cardiovascular death, myocardial infarction [MI], or repeat revascularization), along with stent thrombosis (ST). A total of 285 patients were included, 178 (62.5%) in the provisional stenting group and 87 (37.5%) in the two stent group. After 10 years, no differences in TLR were found at unadjusted analysis (19% vs 25%, p > 0.05) nor after propensity score matching (25% vs 28%, p > 0.05). Similar rates of MACE (60% vs 66%, p > 0.05), death (34% vs 43%, p > 0.05), MI (9% vs 14%, p > 0.05) and ST were also disclosed at propensity-based analysis. Conclusion: Even after 10 year follow-up, patients treated with provisional stenting on left main showed comparable rates of target lesion revascularization compared to two stent strategy.

Original languageEnglish
Pages (from-to)37-42
Number of pages6
JournalInternational Journal of Cardiology
Publication statusPublished - May 15 2016


  • Bifurcation
  • Drug eluting stent
  • Stenting
  • Unprotected left main

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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