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

Yusuke Fujino, Guilherme F. Attizzani, Satoko Tahara, Toru Naganuma, Kensuke Takagi, Hiroto Yabushita, Wei Wang, Kentaro Tanaka, Takahiro Matsumoto, Hiroyoshi Kawamoto, Yuya Yamada, Shinnosuke Amano, Yusuke Watanabe, Takayuki Warisawa, Tomohiko Sato, Satoru Mitomo, Naoyuki Kurita, Hisaaki Ishiguro, Koji Hozawa, Takahiro TsukaharaMasahiro Motosuke, Hiram G. Bezerra, Shotaro Nakamura, Sunao Nakamura

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)284-292
Number of pages9
JournalInternational Journal of Cardiology
Volume230
DOIs
Publication statusPublished - 1 Mar 2017

Keywords

  • Kissing balloon technique
  • Left main coronary artery disease
  • Optical coherence tomography
  • Percutaneous coronary intervention

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