Prognostic impact of final kissing balloon technique after crossover stenting for the left main coronary artery: from th
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ORIGINAL ARTICLE
Prognostic impact of final kissing balloon technique after crossover stenting for the left main coronary artery: from the AOI‑LMCA registry Koji Nishida1 · Mamoru Toyofuku2 · Takeshi Morimoto3 · Masanobu Ohya4 · Yasushi Fuku4 · Hirooki Higami5 · Kyohei Yamaji6 · Hiromi Muranishi6 · Yuhei Yamaji6 · Daisuke Furukawa1 · Tomohisa Tada7 · Euihong Ko2 · Kazushige Kadota4 · Kenji Ando6 · Hiroki Sakamoto7 · Takashi Tamura2 · Kazuya Kawai1 · Takeshi Kimura5 · The AOI LMCA Stenting Registry Investigators Received: 25 January 2018 / Accepted: 2 April 2018 © The Author(s) 2018
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. Keywords Left main coronary artery · Kissing balloon technique · One-stent strategy
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12928-018-0522-0) contains supplementary material, which is available to authorized users. * Takeshi Kimura [email protected]‑u.ac.jp 1
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Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara‑cho, Sakyo‑ku, Kyoto 606‑8507, Japan
Department of Cardiology, Chikamori Hospital, Kochi, Japan
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Department of Cardiology, Japanese Red Cross Society Wakayama Medical Center, Wakayama, Japan
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