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Drug-eluting stent implantation in coronary trifurcation lesions
Shinichi Furuichi1, Giuseppe M Sangiorgi, Altin Palloshi
1San Raffaele Scientific Institute and EMO Centro Cuore Columbus, Milan, Italy.
Insights
Drug-eluting stent (DES) implantation in complex trifurcation lesions shows promising mid-term results. This study found no deaths, heart attacks, or stent clots, indicating safety in treating these challenging coronary artery blockages.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Medicine
Background:
- Trifurcation lesions represent complex coronary anatomy.
- Limited data exists on the outcomes of drug-eluting stent (DES) implantation in these lesions.
Purpose of the Study:
- To assess the mid-term clinical and angiographic outcomes of DES implantation in patients with de novo trifurcation lesions.
Main Methods:
- A cohort of 15 patients with trifurcation lesions treated with DES were analyzed.
- In-hospital and follow-up data were collected, focusing on major adverse cardiac events (MACE).
- MACE included cardiac death, Q-wave myocardial infarction (MI), target lesion revascularization (TLR), and target vessel revascularization (TVR).
Main Results:
- The majority of trifurcation lesions (86.7%) were located in the distal left main coronary artery (LMCA).
- The mean follow-up was 19.0 months.
- Target lesion revascularization (TLR) occurred in 20% of patients, and target vessel revascularization (TVR) in 40%.
- No cardiac deaths, Q-wave MIs, or stent thromboses were observed.
Conclusions:
- Trifurcation lesions frequently occur in the distal LMCA.
- DES implantation in trifurcation lesions is associated with a low incidence of major adverse cardiac events, including death, MI, and stent thrombosis.
Background:
There is no specific study evaluating the outcome of DES implantation in trifurcation lesions.
Objective:
To evaluate the mid-term clinical and angiographic outcome of drug-eluting stent (DES) implantation in trifurcation lesions.
Methods:
All complications and major adverse cardiac events, including cardiac death, Q-wave myocardial infarction (MI), target lesion revascularization (TLR), and target vessel revascularization (TVR) were recorded in-hospital and during clinical follow up.
Results:
A total of 15 consecutive patients undergoing percutaneous coronary intervention with DES in de novo trifurcation lesions were identified. Lesions were located as follows: 13 (86.7%) at the distal left main coronary artery (LMCA) comprising the left anterior descending artery (LAD), the left circumflex artery (LCX) and an intermediate branch; 1 between the LAD, diagonal, and septal branches; and 1 between the LCX, obtuse marginal and posterior lateral branches. Stenting was performed in all 3 branches in 8 patients, in 2 branches in 6 patients, and in 1 branch in 1 patient. The mean follow-up period was 19.0 +/- 8.3 months. TLR occurred in 3 patients (20%) with LMCA lesions. TVR occurred in 6 patients (40%). Of those, 3 were due to TLR, while the other 3 for progression of nontarget lesions. No deaths, Q-wave MIs or stent thromboses were recorded.
Conclusion:
Most trifurcation lesions were found in the distal LMCA. DES implantation in trifurcation lesions can be performed with a low incidence of death, Q-wave MI or stent thrombosis.
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