One-stent Versus Two-stent Techniques for Unprotected Distal Left Main Bifurcational Lesions: Early and Late Outcomes

Abstract

Background and aim: Left main disease account for 3% to 5% of the coronary lesions. PCI on coronary bifurcation lesions is considered a challenge for any cardiologist. These lesions include a wide spectrum of anatomic complexity varying from simple lesions, which can be managed with a single stent, to complex lesions necessitating more complex procedures. The goal of the present study was to compare the clinical outcomes of PCI with single-stent vs. double-stent implantation for the management of ULMCA distal bifurcation lesions. Patients and methods: a total of 60 cases with ULMCA distal bifurcation lesions eligible for PCI were included in the current study. Cases were divided into 2 main groups: one-stent group (20 cases) and two-stents group (40 cases). All patients underwent follow up during hospitalization and post-discharge at 1 and 6 months. Results: Comparison between the study groups as regards the lesional and angiographic characteristics demonstrated that cases in the one-stent group had significantly lower SYNTAX score (21.70 ± 5.58 versus 24.88 ± 4.93, p=0.028) and lower frequency of true bifurcation lesion (65.0 % versus 100.0 %, p0.001) and higher frequency of 1,1.0 Median class (55.0 % versus 7.5 %, p0.001). Besides, both groups had similar early post-interventional outcomes including hematoma and used target vessel revascularization techniques. Also, no significant differences were reported between both groups as regards the 6-month outcome parameters including cardiac death, TV MI, TVR and TL failure. Conclusions: Both single-stent and two-stents techniques are technically feasible and safe techniques for management of ULMCA with comparable outcomes.