Differences of Side Branch Jailing Between Left Main-left Anterior Descending Artery Stenting and Left Main-left Circumflex Artery Stenting with Nobori Biolimus-eluting Stent

Overview

Journal Heart Vessels

Specialty Cardiology & Vascular Diseases

Date 2016 Feb 17

PMID 26879743

Citations 3

Authors

Fumiaki Nakao

Takayuki Okamura

Takeshi Suetomi

Jutaro Yamada

Takeshi Nakamura

Tooru Ueda

Takamasa Oda

Masashi Kanemoto

Yasuhiro Ikeda

Takashi Fujii

Masafumi Yano

Affiliations

Soon will be listed here.

Abstract

The aim of this study is to indicate differences of side branch jailing between the left main (LM)-left anterior descending artery (LAD) stenting and the LM-left circumflex artery (LCx) stenting. Thirty-one patients who underwent single-stenting using a two-link ten-crowns biolimus-eluting stent (Japanese design of BES, J-BES) and subsequent kissing balloon dilation (KBD) on an LM bifurcation with optical coherence tomography (OCT) were divided into two groups according to the stented vessel. Bifurcation angles were measured by three-dimensional (3D) quantitative coronary analysis. The jailing pattern on a side branch ostium was evaluated by stent-enhanced 3D-OCT. Incomplete stent apposition (ISA) after KBD was compared between the stented vessels. The to-be-stented angle of the LM-LCx stenting (n = 11) was significantly steeper than that of the LM-LAD stenting (n = 20) (132.6° ± 16.9° vs. 150.7° ± 10.6°, p < 0.01). The incidence of the free carina type, which has no stent links bridging from a carina, in the LM-LCx stenting was significantly higher than that in the LM-LAD stenting (90.9 vs. 45.0 %, p = 0.02). The percentage of ISA at the bifurcation segment in the LM-LCx stenting was significantly smaller than that in the LM-LAD stenting (4.4 ± 8.2 vs. 12.7 ± 9.2 %, p = 0.0003). This study showed, by higher incidence of the favorable configuration, that the LM-LCx stenting achieved a smaller percentage of ISA than the LM-LAD stenting. These insights may help guide LM bifurcation stenting with J-BES.

Citing Articles

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References

Hildick-Smith D, Lassen J, Koo B . One or two stents for coronary bifurcation lesions?. EuroIntervention. 2011; 6 Suppl J:J61-4. View

Tu S, Hao P, Koning G, Wei X, Song X, Chen A . In vivo assessment of optimal viewing angles from X-ray coronary angiography. EuroIntervention. 2011; 7(1):112-20. DOI: 10.4244/EIJV7I1A19. View

Gil R, Vassilev D, Formuszewicz R, Rusicka-Piekarz T, Doganov A . The carina angle-new geometrical parameter associated with periprocedural side branch compromise and the long-term results in coronary bifurcation lesions with main vessel stenting only. J Interv Cardiol. 2009; 22(6):E1-E10. DOI: 10.1111/j.1540-8183.2009.00492.x. View

Tu S, Koning G, Jukema W, Reiber J . Assessment of obstruction length and optimal viewing angle from biplane X-ray angiograms. Int J Cardiovasc Imaging. 2009; 26(1):5-17. PMC: 2795158. DOI: 10.1007/s10554-009-9509-3. View

Tyczynski P, Ferrante G, Moreno-Ambroj C, Kukreja N, Barlis P, Pieri E . Simple versus complex approaches to treating coronary bifurcation lesions: direct assessment of stent strut apposition by optical coherence tomography. Rev Esp Cardiol. 2010; 63(8):904-14. DOI: 10.1016/s1885-5857(10)70184-5. View

Okamura T, Onuma Y, Yamada J, Iqbal J, Tateishi H, Nao T . 3D optical coherence tomography: new insights into the process of optimal rewiring of side branches during bifurcational stenting. EuroIntervention. 2014; 10(8):907-15. DOI: 10.4244/EIJV10I8A157. View

Myler R, Shaw R, Stertzer S, Hecht H, Ryan C, Rosenblum J . Lesion morphology and coronary angioplasty: current experience and analysis. J Am Coll Cardiol. 1992; 19(7):1641-52. DOI: 10.1016/0735-1097(92)90631-v. View

Hassoon M, de Belder A, Saha M, Hildick-Smith D . Changing the coronary bifurcation angles after stenting procedures: the relevance to the technique and unfavorable outcome (Three-dimensional analysis). Minerva Cardioangiol. 2011; 59(4):309-19. View

Girasis C, Serruys P, Onuma Y, Colombo A, Holmes Jr D, Feldman T . 3-Dimensional bifurcation angle analysis in patients with left main disease: a substudy of the SYNTAX trial (SYNergy Between Percutaneous Coronary Intervention with TAXus and Cardiac Surgery). JACC Cardiovasc Interv. 2010; 3(1):41-8. DOI: 10.1016/j.jcin.2009.10.019. View

10.

Chevalier B, Serruys P, Silber S, Garcia E, Suryapranata H, Hauptmann K . Randomised comparison of Nobori, biolimus A9-eluting coronary stent with a Taxus(R), paclitaxel-eluting coronary stent in patients with stenosis in native coronary arteries: the Nobori 1 trial. EuroIntervention. 2009; 2(4):426-34. View

11.

De Caterina A, Cuculi F, Banning A . Incidence, predictors and management of left main coronary artery stent restenosis: a comprehensive review in the era of drug-eluting stents. EuroIntervention. 2013; 8(11):1326-34. DOI: 10.4244/EIJV8I11A201. View

12.

Ferrante G, Presbitero P, Valgimigli M, Morice M, Pagnotta P, Belli G . Percutaneous coronary intervention versus bypass surgery for left main coronary artery disease: a meta-analysis of randomised trials. EuroIntervention. 2011; 7(6):738-46, 1. DOI: 10.4244/EIJV7I6A117. View

13.

Viceconte N, Tyczynski P, Ferrante G, Foin N, Chan P, Alegria Barrero E . Immediate results of bifurcational stenting assessed with optical coherence tomography. Catheter Cardiovasc Interv. 2012; 81(3):519-28. DOI: 10.1002/ccd.24337. View

14.

Kim B, Ha J, Mintz G, Kim J, Shin D, Ko Y . Randomised comparison of strut coverage between Nobori biolimus-eluting and sirolimus-eluting stents: an optical coherence tomography analysis. EuroIntervention. 2014; 9(12):1389-97. DOI: 10.4244/EIJV9I12A236. View

15.

Okamura T, Matsuzaki M . Sirolimus-eluting stent fracture detection by three-dimensional optical coherence tomography. Catheter Cardiovasc Interv. 2011; 79(4):628-32. DOI: 10.1002/ccd.23268. View

16.

Elbasan Z, Eker Akilli R, Yuksel Kalkan G, Sahin D, Gur M, Cayli M . Predictors of failure of final kissing-balloon inflation after mini-crush stenting in non-left main bifurcation lesions: importance of the main-vessel angle. J Invasive Cardiol. 2013; 25(3):118-22. View

17.

Nakao F . Instant stent-accentuated 3-dimensional optical coherence tomography of a bifurcation lesion treated with reverse minimum overlapping culotte stenting. JACC Cardiovasc Interv. 2014; 7(9):e121-2. DOI: 10.1016/j.jcin.2014.01.176. View

18.

Park S, Park D . Left main stenting: is it a different animal?. EuroIntervention. 2011; 6 Suppl J:J112-7. DOI: 10.4244/EIJV6SUPJA18. View

19.

Tu S, Holm N, Koning G, Maeng M, Reiber J . The impact of acquisition angle differences on three-dimensional quantitative coronary angiography. Catheter Cardiovasc Interv. 2011; 78(2):214-22. DOI: 10.1002/ccd.23047. View

20.

Yang J, Song Y, Song P, Hahn J, Choi S, Choi J . Impact of coronary bifurcation angle on clinical outcomes after percutaneous coronary intervention in real-world practice: results from the COBIS registry. Cardiology. 2012; 122(4):216-24. DOI: 10.1159/000338817. View