Procedural and Clinical Outcomes in Management of Left Main Coronary Artery Bifurcational Lesions

Abstract

Background: Around 20% of percutaneous coronary interventions (PCIs) are used to treat coronary bifurcation syndromes. Technical success was defined as successfully bridging the occluded portion with a wire and balloon and reopening the artery with a 40% residual stenosis in all views. Technical success is defined by the absence of a serious adverse cardiac event throughout the hospital stay (MACE). The purpose of this study was to evaluate the procedural and clinical results associated with LM bifurcational intervention. Methods: A controlled study was carried out on 100 patients eligible to Left Main bifurcational intervention were included. the patients were divided into two groups according to the stenting technique used, the provisional group (n=70) who managed with one stent strategy, and the non-provisional group (n=30) who managed with a double kissing crush, culotte, T stenting, or TAP technique. This study recorded the incidence of MACE: death, non-fatal myocardial infarction, or target lesion revascularizations were recorded at 6 and 12 months of follow-up. Results: It is insignificantly different mortality incidence between the 2 groups but non-fatal myocardial infarction, stent thrombosis, re-PTCA, and target lesion revascularizations were significantly increased in the non-provisional group. As regards clinical success in 2 groups, this study found 68 patients in the provisional group and 24 patients in the non-provisional group fulfilled the characteristics of clinical success. Conclusions: In LM-bifurcational intervention, there is a significant increase in the incidence of MACE in the non-provisional group and so the clinical outcome is better in the provisional stenting than the non-provisional stenting.