Clinical and procedural outcomes of percutaneous coronary intervention for de novo lesions involving the ostial left circumflex coronary artery.
Catheter Cardiovasc Interv
; 102(6): 1048-1056, 2023 11.
Article
em En
| MEDLINE
| ID: mdl-37933728
ABSTRACT
BACKGROUND:
Percutaneous treatment for ostial left circumflex artery (LCx) lesions is known to be associated with suboptimal results.AIMS:
The present study aims to assess the procedural and long-term clinical outcomes of percutaneous coronary intervention (PCI) for de novo ostial LCx lesions overall and according to the coronary revascularization strategy.METHODS:
Consecutive patients undergoing PCI with second generation drug eluting stents or drug coated balloons for de novo ostial LCx lesions in three high-volume Italian centers between 2012 and 2021 were retrospectively evaluated. The primary endpoint was target-vessel revascularization (TVR) at 2 years. Secondary endpoints included major adverse cardiovascular and cerebrovascular events (MACCE), target lesion revascularization, myocardial infarction, stroke, all-cause death, and repeat revascularization.RESULTS:
A total of 366 patients were included in the analysis with a median follow-up of 901 (IQR 450-1728) days. 79.5% of the patients were male, 33.6% were diabetic, 49.7% had a previous PCI, and 23.1% a prior surgical revascularization. Very ostial LCx stenting was performed in 34.1%, crossover from left main to LCx in 17.3%, and a two-stent strategy in 48.6% of cases, respectively. In the overall population, the incidence of TVR at 2 years was 19.0% while MACCE rate was 25.7%. No major differences in clinical outcomes were found according to the stenting strategy. Use of intracoronary imaging was associated with fewer MACCE (HR 0.47, 95% CI 0.25-1.13, p = 0.01), while the diameter of the stent implanted in the ostial LCx was associated with less TVR (HR 0.43, 95% CI 0.25-0.75, p = 0.002).CONCLUSIONS:
Percutaneous revascularization of the ostial LCx is associated with a high rate of TVR, regardless of the stenting strategy. Intracoronary imaging and proper stent sizing may reduce the failure rates.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Doença da Artéria Coronariana
/
Intervenção Coronária Percutânea
Limite:
Female
/
Humans
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Male
Idioma:
En
Ano de publicação:
2023
Tipo de documento:
Article