Early and long‐term results of percutaneous coronary intervention for unprotected left main trifurcation disease

Abstract

Percutaneous treatment of ULM trifurcation disease is feasible, associated with favorable mid-term results, and may be considered given its low invasiveness in patients at high surgical risk or with multiple comorbidities.

Comparison Between the NERS (New Risk Stratification) Score and the SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) Score in Outcome Prediction for Unprotected Left Main Stenting

“…Of note, for double-stent techniques, in concurrence with previous reports (3,4,9,10,23), DK-crush and T-stenting demonstrated lower scores, as compared with classic crush, culotte, and SKS. This finding may be of interest for the practicing interventionalist.…”

Luminal Flow Amplifies Stent-Based Drug Deposition in Arterial Bifurcations

“…We presented the hemodynamic effects on drug distribution patterns using a simplified uniform-cell stent design, though our methodology is adaptable to several types of stents with variable design features. Variability in arterial drug distribution due to other geometric and morphologic aspects such as bifurcation angle, arterial taper as well as presence of a trifurcation [32] can also be understood using our computational framework. Further, performance of a candidate DES using other commonly used stenting procedures for bifurcation lesions such as culotte and crush techniques can be quantified based on their resulting drug distribution patterns and this paradigm can also be extended to predict the effectiveness of dedicated bifurcation stents [33], [34].…”

Left Main Coronary Artery Disease

“…However, only a few studies, including a small number of cases, have evaluated the safety and efficacy of DES implantation in this subset of lesions [79][80][81][82]. However, only a few studies, including a small number of cases, have evaluated the safety and efficacy of DES implantation in this subset of lesions [79][80][81][82].…”

“…Furuichi et al reported the outcomes in 13 patients after DES implantation in de novo distal left main trifurcation lesion. The largest experience of stenting for unprotected left main coronary artery trifurcation disease was reported by Sheiban et al [81]. No deaths, Q-wave myocardial infarctions, or stent thromboses (ST) were recorded [79].…”

“…During a mean follow-up of 19 months, TLR occurred in 23.1% of cases. A MACE rate of 33% (cardiac death 15% and myocardial infarction 4%) and definite ST rate of 3% were recorded, in a total of 27 patients at long-term follow-up (median 28 months) [81]. In a series of 20 patients with left main coronary artery trifurcation treated with DES, Shammas et al reported a 29.4% rate of cumulative MACE (5.3% cardiac death) and 11.8% acute ST, during a median follow-up of about 9 months [80].…”