Impact of different final optimization techniques on long-term clinical outcomes of left main cross-over stenting.


Journal

Cardiovascular revascularization medicine : including molecular interventions
ISSN: 1878-0938
Titre abrégé: Cardiovasc Revasc Med
Pays: United States
ID NLM: 101238551

Informations de publication

Date de publication:
02 2019
Historique:
received: 18 04 2018
revised: 12 05 2018
accepted: 16 05 2018
pubmed: 3 6 2018
medline: 19 3 2020
entrez: 3 6 2018
Statut: ppublish

Résumé

The optimal final optimization technique to be used in patients after Cross Over Left main stenting remainsdebatable. We evaluate the impact of the post-optimization technique (POT), kissing balloon (KB) and the POT-side-POT techniques on both cardiovascular mortality and event-free survival in patients receiving left main (LM) cross-over stenting for an isolated/distal bifurcation LM disease. Clinical and instrumental records of 128 consecutive patients (102 males, mean age 73.39 ± 9.54 years old) with isolated distal/bifurcation LM disease and bypass surgery contraindications or refusal enrolled to receive LM cross-over stenting between the 1st January 2012 and the 1st January 2017 at two institutions: the Rovigo General Hospital (Rovigo, Italy) and the Alexandrovka Hospital University School of Medicine (Sofia, Bulgaria). Patients has been divided into three groups (POT, KB and POT-side-POT) according the optimal final optimization technique used while the 5-year cardiovascular mortality has been evaluated using the log-rank (Mantel-Cox) analysis. Baseline angiographic characteristics of the LM disease were mostly equivalent among the three groups. Over a global follow-up of 61.03 ± 0.92 months, the rates of target vessel revascularization, acute myocardial infarction, and stent thrombosis, were not different among groups. Patients treated with POT had a slightly better long-term survival. None of these optimization techniques appeared to have clearly better long-term outcomes after LM Cross-over stenting in our retrospective study. POT resulted in a slightly better survival compared to Pot-sid-POT and KB.

Sections du résumé

BACKGROUND
The optimal final optimization technique to be used in patients after Cross Over Left main stenting remainsdebatable.
AIM
We evaluate the impact of the post-optimization technique (POT), kissing balloon (KB) and the POT-side-POT techniques on both cardiovascular mortality and event-free survival in patients receiving left main (LM) cross-over stenting for an isolated/distal bifurcation LM disease.
METHODS
Clinical and instrumental records of 128 consecutive patients (102 males, mean age 73.39 ± 9.54 years old) with isolated distal/bifurcation LM disease and bypass surgery contraindications or refusal enrolled to receive LM cross-over stenting between the 1st January 2012 and the 1st January 2017 at two institutions: the Rovigo General Hospital (Rovigo, Italy) and the Alexandrovka Hospital University School of Medicine (Sofia, Bulgaria). Patients has been divided into three groups (POT, KB and POT-side-POT) according the optimal final optimization technique used while the 5-year cardiovascular mortality has been evaluated using the log-rank (Mantel-Cox) analysis.
RESULTS
Baseline angiographic characteristics of the LM disease were mostly equivalent among the three groups. Over a global follow-up of 61.03 ± 0.92 months, the rates of target vessel revascularization, acute myocardial infarction, and stent thrombosis, were not different among groups. Patients treated with POT had a slightly better long-term survival.
CONCLUSIONS
None of these optimization techniques appeared to have clearly better long-term outcomes after LM Cross-over stenting in our retrospective study. POT resulted in a slightly better survival compared to Pot-sid-POT and KB.

Identifiants

pubmed: 29857935
pii: S1553-8389(18)30216-1
doi: 10.1016/j.carrev.2018.05.014
pii:
doi:

Types de publication

Comparative Study Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

108-112

Commentaires et corrections

Type : CommentIn
Type : CommentIn

Informations de copyright

Copyright © 2018 Elsevier Inc. All rights reserved.

Auteurs

Gianluca Rigatelli (G)

Cardiovascular Diagnosis and Endoluminal Interventions Unit, Rovigo General Hospital, Rovigo, Italy. Electronic address: jackyheart71@yahoo.it.

Marco Zuin (M)

Section of Internal and Cardiopulmonary Medicine, Department of Medical Science, University of Ferrara, Ferrara, Italy.

Kiril Karamfilof (K)

Cardiology and Interventional Cardiology Department, Alexandrovska University School of Medicine, Sofia, Bulgaria.

Daniele Cavazzini (D)

Cardiology Department, Adria General Hospital, Rovigo, Italy.

Gabriele Braggion (G)

Cardiology Department, Adria General Hospital, Rovigo, Italy.

Stefano Perilli (S)

Cardiology Department, Adria General Hospital, Rovigo, Italy.

Dobrin Vassilev (D)

Cardiology and Interventional Cardiology Department, Alexandrovska University School of Medicine, Sofia, Bulgaria.

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