Stenting strategy and imaging use in left main percutaneous coronary intervention: insights from a 15-year registry.

IF 1.6 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Future cardiology Pub Date : 2025-06-06 DOI:10.1080/14796678.2025.2511416

Judit Andreka, Fazila-Tun-Nesa Malik, Mariam Khandaker, Kalim Uddin, Abdul Kayum, Anass Maaroufi, Dan Prunea, Zoltan Ruzsa, Gabor G Toth

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引用次数: 0

Abstract

Background: Left main (LM) percutaneous coronary intervention (PCI) remains a major interventional challenge, with outcomes influenced by various patient- and procedure-related factors.

Objectives: To analyze procedural characteristics and outcomes of patients who underwent LM PCI over a 15-year period in a single center.

Methods: We retrospectively analyzed data from all consecutive patients who underwent LM PCI between 2006 and 2022. Procedural details, with a focus on stenting technique, were collected. Primary outcome was all-cause mortality at 1 year.

Results: In total 3494 patients were included. The majority (67%) presented with chronic coronary syndrome. Seventy-seven percent of all patients (n = 2690) underwent PCI by single stent (SS) strategy and 23% (n = 804) by double stent (DS) strategy. One-year mortality was significantly lower in SS cases compared to DS (3.5% vs. 5.1%, HR 0.64, 95% CI 0.43-0.96). Intravascular imaging was used in 17% of the cases but showed no significant difference in one-year mortality compared to angio-guided PCI (4.8% vs. 3.7%; HR 1.11, 95% CI 0.71-1.73).

Conclusions: In real-world LM PCI practice, patients for whom a provisional single-stent strategy was feasible had better outcomes than those requiring a double-stent approach.

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左主干经皮冠状动脉介入治疗支架置入策略和影像学应用：来自15年登记的见解。

背景：左主干（LM）经皮冠状动脉介入治疗（PCI）仍然是一个主要的介入挑战，其结果受到各种患者和手术相关因素的影响。目的：分析单中心15年间行LM PCI患者的手术特点和结果。方法：我们回顾性分析了2006年至2022年间所有连续接受LM PCI的患者的数据。收集了手术细节，重点是支架置入技术。主要终点是1年时的全因死亡率。结果：共纳入3494例患者。大多数（67%）表现为慢性冠状动脉综合征。77%的患者（n = 2690）采用单支架（SS）策略，23% （n = 804）采用双支架（DS）策略。与DS相比，SS患者一年死亡率显著降低（3.5% vs. 5.1%, HR 0.64, 95% CI 0.43-0.96）。17%的病例使用了血管内显像，但与血管引导下的PCI相比，一年死亡率无显著差异(4.8% vs 3.7%；Hr 1.11, 95% ci 0.71-1.73)。结论：在现实的LM PCI实践中，临时单支架策略可行的患者比需要双支架方法的患者有更好的结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Future cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

2.80

自引率

5.90%

发文量

期刊介绍： Research advances have contributed to improved outcomes across all specialties, but the rate of advancement in cardiology has been exceptional. Concurrently, the population of patients with cardiac conditions continues to grow and greater public awareness has increased patients" expectations of new drugs and devices. Future Cardiology (ISSN 1479-6678) reflects this new era of cardiology and highlights the new molecular approach to advancing cardiovascular therapy. Coverage will also reflect the major technological advances in bioengineering in cardiology in terms of advanced and robust devices, miniaturization, imaging, system modeling and information management issues.