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Sirolimus‐eluting BiOSS LIM dedicated bifurcation stent in the treatment of unprotected distal left main stenosis
Author(s) -
Briguori Carlo,
Visconti Gabriella,
Golino Marco,
Focaccio Amelia,
Signoriello Giuseppe
Publication year - 2019
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.28132
Subject(s) - medicine , stent , timi , clinical endpoint , cardiology , stenosis , coronary arteries , nuclear medicine , radiology , percutaneous coronary intervention , artery , myocardial infarction , randomized controlled trial
Background Proximal optimization technique (POT) has been proposed to adapt the conventional drug‐eluting stent (DES) with the fractal anatomy of the bifurcation. However, only few DES are labeled for post‐expansion beyond 5.0 mm. Furthermore, recrossing in the side branch (SB) through the main vessel (MV) stent cells may be challenging. Objectives To compare the sirolimus‐eluting, balloon‐expandable dedicated bifurcation stent BiOSS LIM DES versus the second generation DES in the treatment of distal unprotected left main coronary arteries (ULMCAs) lesions. Methods Forty‐two consecutive patients with distal ULMCA lesions were treated with the BiOSS LIM (BiOSS LIM group) in our center. A matched‐group of patients treated with second‐generation DES was selected from our database (Control group). The primary endpoint was the procedural complication rate, including (a) SB occlusion, defined as intraprocedural TIMI flow grade <3 immediately after MV stenting; and/or (b) trouble in SB access, defined as the need of ≥2 guidewires or a failure to recross in the SB trough the MV stent cells. The need of POT in the two groups was also analyzed. Results The primary endpoint occurred in four (9.5%) patients in the BiOSS LIM group and in 13 (31%) in the Control group ( p = 0.028; OR = 4.25; 95% confidence interval: 1.25–14.43). POT was performed more often in the Control group (71% vs. 35%; p = 0.004). Conclusions Compared to conventional DES, the BiOSS LIM stent (1) facilitates SB recrossing and (2) fits well with the fractal anatomy of the left main bifurcation.