Influence of final kissing balloon inflation on long-term outcomes after PCI of distal left main bifurcation lesions In the EXCEL trial

被引:17
作者
Kini, Annapoorna S. [1 ,2 ]
Dangas, George D. [1 ,2 ,3 ]
Baber, Usman [1 ,2 ]
Vengrenyuk, Yuliya [1 ,2 ]
Kandzari, David E. [4 ]
Leon, Martin B. [3 ,5 ]
Morice, Marie-Claude [6 ]
Serruys, Patrick W. [7 ,8 ]
Kappetein, Arie Pieter [9 ]
Sabik, Joseph F., III [10 ]
Dressler, Ovidiu [1 ,2 ]
Mehran, Roxana [1 ,2 ,3 ]
Sharma, Samin [1 ,2 ]
Stone, Gregg W. [1 ,2 ,3 ]
机构
[1] Mt Sinai Hosp, One Gustave L Levy Pl,Box 1030, New York, NY 10029 USA
[2] Icahn Sch Med Mt Sinai, New York, NY 10029 USA
[3] Cardiovasc Res Fdn, Clin Trials Ctr, New York, NY USA
[4] Piedmont Heart Inst, Atlanta, GA USA
[5] Columbia Univ, NewYork Presbyterian Hosp, Med Ctr, New York, NY USA
[6] Hop Prive Cartier, Ramsay Gen Sante, Massy, France
[7] Natl Univ Ireland, Dept Cardiol, NUIG, Galway, Ireland
[8] Imperial Coll Sci Technol & Med, London, England
[9] Erasmus MC, Thoraxctr, Rotterdam, Netherlands
[10] UH Cleveland Med Ctr, Dept Surg, Cleveland, OH USA
关键词
bifurcation; drug-eluting stent; left main; CORONARY-ARTERY-DISEASE; DRUG-ELUTING STENTS; CLINICAL-OUTCOMES; RANDOMIZED-TRIAL; FOLLOW-UP; CRUSH; DEFORMATION; DILATATION; SURGERY; IMPACT;
D O I
10.4244/EIJ-D-19-00851
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims: The impact of final kissing balloon inflation (FKBI) after percutaneous coronary intervention (PCI) of bifurcation lesions on long-term clinical outcomes remains controversial. We sought to determine the impact of FKBI on four-year outcomes after PCI of distal left main (LM) bifurcation lesions. Methods and results: The EXCEL trial compared PCI with everolimus-eluting stents and coronary artery bypass graft surgery (CABG) in patients with left main (LM) disease. We examined four-year clinical outcomes after PCI of distal LM bifurcation lesions according to use of FKBI. The primary endpoint was the composite rate of death, myocardial infarction (MI), or stroke. The major secondary endpoint was the composite rate of death, ML stroke, or ischaemia-driven revascularisation (IDR). Among 948 patients randomised to PCI, 759 had distal LM lesions treated, 430 of which were treated with one stent and 329 of which were treated with two or more stents. The four-year rates of the primary and major secondary endpoints were similar with versus without FKBI in both the one-stent and >= 2-stent groups in both unadjusted and adjusted analyses. Conclusions: In the EXCEL trial, the performance of FKBI after PCI of distal LM bifurcation lesions was not associated with improved four-year clinical outcomes regardless of whether one stent or >= 2 stents were implanted.
引用
收藏
页码:218 / +
页数:17
相关论文
共 26 条
[1]   Double Kissing Crush Versus Provisional Stenting for Left Main Distal Bifurcation Lesions [J].
Chen, Shao-Liang ;
Zhang, Jue-Jie ;
Han, Yaling ;
Kan, Jing ;
Chen, Lianglong ;
Qiu, Chunguang ;
Jiang, Tiemin ;
Tao, Ling ;
Zeng, Hesong ;
Li, Li ;
Xia, Yong ;
Gao, Chuanyu ;
Santoso, Teguh ;
Paiboon, Chootopol ;
Wang, Yan ;
Kwan, Tak W. ;
Ye, Fei ;
Tian, Nailiang ;
Liu, Zhizhong ;
Lin, Song ;
Lu, Chengzhi ;
Wen, Shangyu ;
Hong, Lang ;
Zhang, Qi ;
Sheiban, Imad ;
Xu, Yawei ;
Wang, Lefeng ;
Rab, Tanveer S. ;
Li, Zhanquan ;
Cheng, Guanchang ;
Cui, Lianqun ;
Leon, Martin B. ;
Stone, Gregg W. .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2017, 70 (21) :2605-2617
[2]   A Randomized Clinical Study Comparing Double Kissing Crush With Provisional Stenting for Treatment of Coronary Bifurcation Lesions Results From the DKCRUSH-II (Double Kissing Crush versus Provisional Stenting Technique for Treatment of Coronary Bifurcation Lesions) Trial [J].
Chen, Shao-Liang ;
Santoso, Teguh ;
Zhang, Jun-Jie ;
Ye, Fei ;
Xu, Ya-Wei ;
Fu, Qiang ;
Kan, Jing ;
Paiboon, Chitprapai ;
Zhou, Yong ;
Ding, Shi-Qing ;
Kwan, Tak W. .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2011, 57 (08) :914-920
[3]   Randomized Study of the Crush Technique Versus Provisional Side-Branch Stenting in True Coronary Bifurcations The CACTUS (Coronary Bifurcations: Application of the Crushing Technique Using Sirolimus-Eluting Stents) Study [J].
Colombo, Antonio ;
Bramucci, Ezio ;
Sacca, Salvatore ;
Violini, Roberto ;
Lettieri, Corrado ;
Zanini, Roberto ;
Sheiban, Imad ;
Paloscia, Leonardo ;
Grube, Eberhard ;
Schofer, Joachim ;
Bolognese, Leonardo ;
Orlandi, Mario ;
Niccoli, Giampaolo ;
Latib, Azeem ;
Airoldi, Flavio .
CIRCULATION, 2009, 119 (01) :71-U118
[4]   Provisional vs. two-stent technique for unprotected left main coronary artery disease after ten years follow up: A propensity matched analysis [J].
D'Ascenzo, Fabrizio ;
Iannaccone, Mario ;
Giordana, Francesca ;
Chieffo, Alaide ;
Connor, Stephen O. ;
Napp, L. Christian ;
Chandran, SujaySubash ;
de la Torre Hernandez, Jose Maria ;
Chen, Shao-Liang ;
Varbella, Ferdinando ;
Omede, Pierluigi ;
Taha, Salma ;
Meliga, Emanuele ;
Kawamoto, Hiroyoshi ;
Montefusco, Antonio ;
Chong, Mervyn ;
Garot, Philippe ;
Sin, Lin ;
Gasparetto, Valeria ;
Abdirashid, Mohamed ;
Cerrato, Enrico ;
Biondi-Zoccai, Giuseppe ;
Gaita, Fiorenzo ;
Escaned, Javier ;
Smith, David Hiddick ;
Lefevre, Thierry ;
Colombo, Antonio ;
Sheiban, Imad ;
Moretti, Claudio .
INTERNATIONAL JOURNAL OF CARDIOLOGY, 2016, 211 :37-42
[5]   Ultrasound Findings During Percutaneous Treatment of Bifurcated Coronary Lesions [J].
de Lezo, Javier Suarez ;
Medina, Alfonso ;
Martin, Pedro ;
Amador, Celestina ;
Delgado, Antonio ;
de Lezo, Jose Suarez ;
Pan, Manuel ;
Hernandez, Enrique ;
Melian, Francisco ;
Arbelo, Elena ;
Garcia, Antonio .
REVISTA ESPANOLA DE CARDIOLOGIA, 2008, 61 (09) :930-935
[6]   Three-dimensional numerical simulations of physiological flows in a stented coronary bifurcation [J].
Deplano, V ;
Bertolotti, C ;
Barragan, P .
MEDICAL & BIOLOGICAL ENGINEERING & COMPUTING, 2004, 42 (05) :650-659
[7]   Randomized trial on routine vs. provisional T-stenting in the treatment of de novo coronary bifurcation lesions [J].
Ferenc, Miroslaw ;
Gick, Michael ;
Kienzle, Rolf-Peter ;
Bestehorn, Hans-Peter ;
Werner, Klaus-Dieter ;
Comberg, Thomas ;
Kuebler, Piotr ;
Buettner, Heinz Joachim ;
Neumann, Franz-Josef .
EUROPEAN HEART JOURNAL, 2008, 29 (23) :2859-2867
[8]   Clinical and angiographic outcome after implantation of drug-eluting stents in bifurcation lesions with the crush stent technique - Importance of final kissing balloon post-dilation [J].
Ge, L ;
Airoldi, F ;
Iakovou, I ;
Md, JC ;
Michev, I ;
Sangiorgi, GM ;
Montorfano, M ;
Chieffo, A ;
Carlino, M ;
Corvaja, N ;
Colombo, A .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2005, 46 (04) :613-620
[9]   Treatment of bifurcation lesions with two stents: one year angiographic and clinical follow up of crush versus T stenting [J].
Ge, L ;
Iakovou, I ;
Cosgrave, J ;
Agostoni, P ;
Airoldi, F ;
Sangiorgi, GM ;
Michev, I ;
Chieffo, A ;
Montorfano, M ;
Carlino, N ;
Corvaja, N ;
Colombo, A .
HEART, 2006, 92 (03) :371-376
[10]   Drug-Eluting Stents in Bifurcations Bench Study of Strut Deformation and Coating Lesions [J].
Guerin, Patrice ;
Pilet, Paul ;
Finet, Gerard ;
Goueffic, Yann ;
N'Guyen, Jean Michel ;
Crochet, Dominique ;
Tijou, Isabelle ;
Pacaud, Pierre ;
Loirand, Gervaise .
CIRCULATION-CARDIOVASCULAR INTERVENTIONS, 2010, 3 (02) :120-126