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Impact of a combination of full coverage stenting and proximal optimization technique on long term outcome for

Kensuke Takagi1, Yusuke Fujino1, Toru Naganuma1

  • 1Department of Cardiology, New Tokyo Hospital; Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan.

Cardiovascular Revascularization Medicine : Including Molecular Interventions
|October 11, 2016
PubMed

Insights

An optimal percutaneous coronary intervention (PCI) strategy using full-coverage stenting and proximal optimization technique (POT) may reduce major adverse cardiovascular events (MACE) in unprotected distal left main (UDLM) lesions, particularly target lesion revascularization.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Medicine

Background:

  • Percutaneous coronary intervention (PCI) for unprotected distal left main (UDLM) lesions lacks a consensus approach.
  • Drug-eluting stents are commonly used for UDLM stenosis.

Purpose of the Study:

  • To clarify the impact of combining full-coverage stenting and proximal optimization technique (POT) for UDLM lesions.
  • To evaluate the effectiveness of an optimal PCI strategy in reducing major adverse cardiovascular events (MACE) and target lesion revascularization (TLR).

Main Methods:

  • A study involving 586 patients with UDLM stenosis treated with drug-eluting stents between April 2005 and August 2011.
  • Comparison of an optimal strategy (full-coverage stenting + POT) in 353 patients versus non-optimal treatment in 233 patients.
  • Assessment of MACE (all-cause death, myocardial infarction, TLR) and main branch (MB) restenosis during follow-up.

Main Results:

  • At 1615 days, MACE occurred in 28.3% of patients.
  • The optimal strategy showed a trend towards lower MACE and TLR (p=0.05 and p=0.06, respectively).
  • Significantly less TLR of the MB was observed with the optimal strategy (p=0.008).

Conclusions:

  • An optimal PCI strategy combining full-coverage stenting and POT appears effective for UDLM lesions.
  • This approach may reduce MACE, primarily by decreasing main branch restenosis.
  • The findings support the use of this optimized technique for UDLM interventions.
Abstract

Keywords:
Distal left main diseaseDrug-eluting stentFull coverageProximal optimization technique

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