Comparison of Simple and Complex Stenting Techniques in the Treatment of Unprotected Left Main Coronary Artery Bifurcation Stenosis

Young Hak Kim, Seong Wook Park, Myeong Ki Hong, Duk Woo Park, Kyoung Min Park, Bong Ki Lee, Jong Min Song, Ki Hoon Han, Cheol Whan Lee, Duk Hyun Kang, Jae Kwan Song, Jae Joong Kim, Seung Jung Park

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110 Citations (Scopus)

Abstract

We assessed the safety and feasibility of various stenting techniques using the sirolimus-eluting stent (SES) in the treatment of unprotected left main coronary artery (LMCA) bifurcation stenoses. One hundred sixteen patients with unprotected LMCA bifurcation stenoses underwent SES implantation. A simple stenting technique (simple group, n = 67) across the left circumflex artery (LCx) and a complex technique (complex group) comprising "kissing" stenting (n = 24) or a "crush" (n = 25) technique were used. Baseline clinical and angiographic characteristics were similar for the 2 groups, except for more multivessel involvement and narrower LCxs in the complex group. The procedural success rate was 100%. Angiographic restenosis rate at 6 months was lower in the simple group (5.3%) than in the complex group (24.4%, p = 0.024). In the complex group, restenosis rates were similar for the kissing (25.0%) and crush (23.8%) techniques (p = 1.0). There were no incidents of death or myocardial infarction during follow-up (median 18.6 months). Target lesion revascularization was performed in 6 patients only in the complex group (0% vs 12.2%, p = 0.005). At 18 months, survival rates without target lesion revascularization were 100 ± 0% in the simple group and 85.7 ± 5.6% in the complex group (p = 0.004). In conclusion, SES implantation for unprotected LMCA bifurcation stenoses appears to be safe and effective. Compared with the complex stenting technique, the simple technique was technically easier and appeared to be more effective in improving long-term outcomes in patients with normal LCxs.

Original languageEnglish
Pages (from-to)1597-1601
Number of pages5
JournalAmerican Journal of Cardiology
Volume97
Issue number11
DOIs
Publication statusPublished - 2006 Jun 1

Bibliographical note

Funding Information:
This study was supported in part by the CardioVascular Research Foundation, Seoul, Korea, by Grant 0412-CR02-0704-0001 from the Korea Health 21 R&D Project, Ministry of Health and Welfare, Seoul, Korea, and by Grants 2004-361 and 2005-361 from the Asan Institute for Life Sciences, Seoul, Korea.

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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