TY - JOUR
T1 - Difference in vascular response between sirolimus-eluting- and everolimus-eluting stents in ostial left circumflex artery after unprotected left main as observed by optical coherence tomography
AU - Fujino, Yusuke
AU - Attizzani, Guilherme F.
AU - Tahara, Satoko
AU - Naganuma, Toru
AU - Takagi, Kensuke
AU - Yabushita, Hiroto
AU - Wang, Wei
AU - Tanaka, Kentaro
AU - Matsumoto, Takahiro
AU - Kawamoto, Hiroyoshi
AU - Yamada, Yuya
AU - Amano, Shinnosuke
AU - Watanabe, Yusuke
AU - Warisawa, Takayuki
AU - Sato, Tomohiko
AU - Mitomo, Satoru
AU - Kurita, Naoyuki
AU - Ishiguro, Hisaaki
AU - Hozawa, Koji
AU - Tsukahara, Takahiro
AU - Motosuke, Masahiro
AU - Bezerra, Hiram G.
AU - Nakamura, Shotaro
AU - Nakamura, Sunao
N1 - Publisher Copyright:
© 2016 Elsevier Ireland Ltd
PY - 2017/3/1
Y1 - 2017/3/1
N2 - Background Kissing-balloon technique (KBT) is commonly performed during percutaneous coronary intervention of distal unprotected left main coronary artery (ULM) aiming at obtaining optimal opening of the side branch (left circumflex artery; LCX) ostium. Nonetheless, detailed evaluation of vascular response to stents in LCX ostium is lacking. We therefore evaluated the vascular response to different drug-eluting stents (DES) in ostial LCX after ULM by means of optical coherence tomography (OCT). Methods We prospectively enrolled 38 consecutive patients with ULM disease, who were treated with single-stent procedure using DES, crossover the ULM-left anterior descending artery (LAD) followed by KBT. Twelve patients were treated with sirolimus-eluting stents (SES) and 26 patients were treated with everolimus-eluting stents (EES). OCT was conducted at post-PCI and 9-month follow-up. We evaluated the DES–vessel interactions and number of stent struts at the side branch (LCX) ostium (SO) at post-PCI, and compared the narrowing of ostial area at LCX between SES and EES. Results Post-procedure, the number of stent struts at SO was significantly higher in SES compared to EES (median 14.47% vs 0.19%, p < 0.001). The narrowing of LCX ostial area at follow-up was more pronounced in SES compared with EES (29.16% vs 2.46%, respectively, p < 0.001). Linear regression analysis showed a high correlation between the number of stent struts in LCX ostium and ostial area narrowing (r = 0.771, p < 0.001). Conclusions OCT showed differences between EES– and SES–vessel interactions at ULM bifurcation PCI. Number of LCX ostium struts at post-PCI impacted the narrowing of ostial area at 9-month follow-up.
AB - Background Kissing-balloon technique (KBT) is commonly performed during percutaneous coronary intervention of distal unprotected left main coronary artery (ULM) aiming at obtaining optimal opening of the side branch (left circumflex artery; LCX) ostium. Nonetheless, detailed evaluation of vascular response to stents in LCX ostium is lacking. We therefore evaluated the vascular response to different drug-eluting stents (DES) in ostial LCX after ULM by means of optical coherence tomography (OCT). Methods We prospectively enrolled 38 consecutive patients with ULM disease, who were treated with single-stent procedure using DES, crossover the ULM-left anterior descending artery (LAD) followed by KBT. Twelve patients were treated with sirolimus-eluting stents (SES) and 26 patients were treated with everolimus-eluting stents (EES). OCT was conducted at post-PCI and 9-month follow-up. We evaluated the DES–vessel interactions and number of stent struts at the side branch (LCX) ostium (SO) at post-PCI, and compared the narrowing of ostial area at LCX between SES and EES. Results Post-procedure, the number of stent struts at SO was significantly higher in SES compared to EES (median 14.47% vs 0.19%, p < 0.001). The narrowing of LCX ostial area at follow-up was more pronounced in SES compared with EES (29.16% vs 2.46%, respectively, p < 0.001). Linear regression analysis showed a high correlation between the number of stent struts in LCX ostium and ostial area narrowing (r = 0.771, p < 0.001). Conclusions OCT showed differences between EES– and SES–vessel interactions at ULM bifurcation PCI. Number of LCX ostium struts at post-PCI impacted the narrowing of ostial area at 9-month follow-up.
KW - Kissing balloon technique
KW - Left main coronary artery disease
KW - Optical coherence tomography
KW - Percutaneous coronary intervention
UR - http://www.scopus.com/inward/record.url?scp=85008471601&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2016.12.122
DO - 10.1016/j.ijcard.2016.12.122
M3 - Article
C2 - 28065691
AN - SCOPUS:85008471601
SN - 0167-5273
VL - 230
SP - 284
EP - 292
JO - International Journal of Cardiology
JF - International Journal of Cardiology
ER -