Prognostic impact of final kissing balloon technique after crossover stenting for the left main coronary artery: from the AOI-LMCA registry View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2018-04-24

AUTHORS

Koji Nishida, Mamoru Toyofuku, Takeshi Morimoto, Masanobu Ohya, Yasushi Fuku, Hirooki Higami, Kyohei Yamaji, Hiromi Muranishi, Yuhei Yamaji, Daisuke Furukawa, Tomohisa Tada, Euihong Ko, Kazushige Kadota, Kenji Ando, Hiroki Sakamoto, Takashi Tamura, Kazuya Kawai, Takeshi Kimura, The AOI LMCA Stenting Registry Investigators

ABSTRACT

It is still uncertain whether the final kissing balloon technique (FKBT) is mandatory after crossover stenting for the left main coronary artery (LMCA). Assessing Optimal Percutaneous Coronary Intervention for LMCA (AOI-LMCA) registry, a 6-center retrospective registry, enrolled 1809 consecutive patients for LMCA stenting in Japan. In the present analysis, 5-year clinical outcomes were compared between non-FKBT (n = 160) and FKBT (n = 578) groups in patients treated with crossover stenting with drug-eluting stents from the LMCA to the left anterior descending artery. Propensity score-matched analysis was also performed in 160 patient pairs. In the entire study population as well as in the propensity-matched population, the cumulative 5-year incidence of the primary outcome measure (target lesion revascularization: TLR) was not significantly different between the FKBT and non-FKBT groups (10.7 versus 14.3%, P = 0.49, and 11.8 versus 14.3%, P = 0.53, respectively). In the sensitivity analysis by the multivariable Cox proportional hazard model, the effect of FKBT relative to non-FKBT for TLR remained insignificant (adjusted HR 0.89, 95% CI 0.47–1.69, P = 0.72). Regarding the TLR location, there were no significant differences in the cumulative incidences of TLR for LMCA-only, for the main branch, and for the side branch between the 2 groups (2.2 versus 1.3%, P = 0.93, 11.8 versus 9.1%, P = 0.71, and 8.2 versus 7.6%, P = 0.82, respectively). FKBT after a 1-stent strategy for LMCA crossover stenting did not affect TLR and other clinical outcomes during 5-year follow-up.Clinical Trial Registration: Assessing Optimal Percutaneous Coronary Intervention for Left Main Coronary Artery Stenting Registry (AOI LMCA Stenting Registry). http://www.umin.ac.jp/ctr/index/htm/. Unique Identifier: UMIN000014706. More... »

PAGES

197-206

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s12928-018-0522-0

DOI

http://dx.doi.org/10.1007/s12928-018-0522-0

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1103624907

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/29691767


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22 schema:description It is still uncertain whether the final kissing balloon technique (FKBT) is mandatory after crossover stenting for the left main coronary artery (LMCA). Assessing Optimal Percutaneous Coronary Intervention for LMCA (AOI-LMCA) registry, a 6-center retrospective registry, enrolled 1809 consecutive patients for LMCA stenting in Japan. In the present analysis, 5-year clinical outcomes were compared between non-FKBT (n = 160) and FKBT (n = 578) groups in patients treated with crossover stenting with drug-eluting stents from the LMCA to the left anterior descending artery. Propensity score-matched analysis was also performed in 160 patient pairs. In the entire study population as well as in the propensity-matched population, the cumulative 5-year incidence of the primary outcome measure (target lesion revascularization: TLR) was not significantly different between the FKBT and non-FKBT groups (10.7 versus 14.3%, P = 0.49, and 11.8 versus 14.3%, P = 0.53, respectively). In the sensitivity analysis by the multivariable Cox proportional hazard model, the effect of FKBT relative to non-FKBT for TLR remained insignificant (adjusted HR 0.89, 95% CI 0.47–1.69, P = 0.72). Regarding the TLR location, there were no significant differences in the cumulative incidences of TLR for LMCA-only, for the main branch, and for the side branch between the 2 groups (2.2 versus 1.3%, P = 0.93, 11.8 versus 9.1%, P = 0.71, and 8.2 versus 7.6%, P = 0.82, respectively). FKBT after a 1-stent strategy for LMCA crossover stenting did not affect TLR and other clinical outcomes during 5-year follow-up.Clinical Trial Registration: Assessing Optimal Percutaneous Coronary Intervention for Left Main Coronary Artery Stenting Registry (AOI LMCA Stenting Registry). http://www.umin.ac.jp/ctr/index/htm/. Unique Identifier: UMIN000014706.
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29 Japan
30 LMCA (AOI-LMCA) registry
31 LMCA stenting
32 TLR
33 analysis
34 anterior
35 artery
36 balloon technique
37 branches
38 clinical outcomes
39 consecutive patients
40 coronary artery
41 coronary intervention
42 crossover
43 crossover stenting
44 cumulative incidence
45 differences
46 drug-eluting stents
47 effect
48 entire study population
49 final kissing balloon technique
50 group
51 hazards model
52 impact
53 incidence
54 intervention
55 kissing balloon technique
56 left anterior
57 left main coronary artery
58 location
59 main branches
60 main coronary artery
61 measures
62 model
63 multivariable Cox proportional hazards models
64 optimal percutaneous coronary intervention
65 outcome measures
66 outcomes
67 pairs
68 patient pairs
69 patients
70 percutaneous coronary intervention
71 population
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73 primary outcome measure
74 prognostic impact
75 propensity score-matched analysis
76 propensity-matched population
77 proportional hazards model
78 registry
79 retrospective registry
80 sensitivity analysis
81 side branches
82 significant differences
83 stenting
84 stents
85 strategies
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