One-stent versus two-stent techniques for distal unprotected left main coronary artery bifurcation lesions

To assess the clinical outcomes of percutaneous coronary intervention (PCI) with single-stent versus double-stents implantation in distal unprotected left main coronary artery (ULMCA) bifurcation lesions and evaluate their merits and demerits in this clinical setting.

88 patients with distal ULMCA bifurcation lesions and treated with PCI with single or double stents implantation (50 in the one-stent group and 38 in the two-stent group) was included.

No significant difference in the number of left main and multivessel disease, stenosis rate of left main, inner diameter of left main vessel, and distal bifurcation angle was noted. The procedural success rate was 100%. Single-stent group had significantly lower ostial residual stenosis of left anterior descending and higher ostial residual stenosis of left circumflex as compared to double-stent group. During the hospitalization period, no major adverse cardiovascular events were observed in the two groups. During the follow-up period, restenosis was observed in 1 case in single-stent group and in 2 cases in double-stent group, respectively. Recurrence of angina and target lesion revascularization was observed in 6 and 1 case in single-stent group, and 4 and 2 cases in double-stent group, respectively. There was no acute myocardial infarction, in-stent thrombosis and cardiac death in both of the groups.

Both stenting strategies were feasible for distal ULMCA bifurcation lesions with a high operation success rate and safety. Single-stent technique had lower ostial residual stenosis of left anterior descending whereas double-stents technique had lower ostial residual stenosis of left circumflex.