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

Research output: Contribution to journalArticle

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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

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Coronary Stenosis
Sirolimus
Stents
Therapeutics
Survival Rate
Arteries
Myocardial Infarction
Safety

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Kim, Young Hak ; Park, Seong Wook ; Hong, Myeong Ki ; Park, Duk Woo ; Park, Kyoung Min ; Lee, Bong Ki ; Song, Jong Min ; Han, Ki Hoon ; Lee, Cheol Whan ; Kang, Duk Hyun ; Song, Jae Kwan ; Kim, Jae Joong ; Park, Seung Jung. / Comparison of Simple and Complex Stenting Techniques in the Treatment of Unprotected Left Main Coronary Artery Bifurcation Stenosis. In: American Journal of Cardiology. 2006 ; Vol. 97, No. 11. pp. 1597-1601.
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title = "Comparison of Simple and Complex Stenting Techniques in the Treatment of Unprotected Left Main Coronary Artery Bifurcation Stenosis",
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.",
author = "Kim, {Young Hak} and Park, {Seong Wook} and Hong, {Myeong Ki} and Park, {Duk Woo} and Park, {Kyoung Min} and Lee, {Bong Ki} and Song, {Jong Min} and Han, {Ki Hoon} and Lee, {Cheol Whan} and Kang, {Duk Hyun} and Song, {Jae Kwan} and Kim, {Jae Joong} and Park, {Seung Jung}",
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Kim, YH, Park, SW, Hong, MK, Park, DW, Park, KM, Lee, BK, Song, JM, Han, KH, Lee, CW, Kang, DH, Song, JK, Kim, JJ & Park, SJ 2006, 'Comparison of Simple and Complex Stenting Techniques in the Treatment of Unprotected Left Main Coronary Artery Bifurcation Stenosis', American Journal of Cardiology, vol. 97, no. 11, pp. 1597-1601. https://doi.org/10.1016/j.amjcard.2005.12.051

Comparison of Simple and Complex Stenting Techniques in the Treatment of Unprotected Left Main Coronary Artery Bifurcation Stenosis. / Kim, Young Hak; Park, Seong Wook; Hong, Myeong Ki; Park, Duk Woo; Park, Kyoung Min; Lee, Bong Ki; Song, Jong Min; Han, Ki Hoon; Lee, Cheol Whan; Kang, Duk Hyun; Song, Jae Kwan; Kim, Jae Joong; Park, Seung Jung.

In: American Journal of Cardiology, Vol. 97, No. 11, 01.06.2006, p. 1597-1601.

Research output: Contribution to journalArticle

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T1 - Comparison of Simple and Complex Stenting Techniques in the Treatment of Unprotected Left Main Coronary Artery Bifurcation Stenosis

AU - Kim, Young Hak

AU - Park, Seong Wook

AU - Hong, Myeong Ki

AU - Park, Duk Woo

AU - Park, Kyoung Min

AU - Lee, Bong Ki

AU - Song, Jong Min

AU - Han, Ki Hoon

AU - Lee, Cheol Whan

AU - Kang, Duk Hyun

AU - Song, Jae Kwan

AU - Kim, Jae Joong

AU - Park, Seung Jung

PY - 2006/6/1

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N2 - 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.

AB - 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.

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