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Abstract

Objective: To identify the outcomes of provisional single stent (PS) strategy without final kissing balloon (FKB) in wide angle (≥90°) distal bifurcation of the left main stem (LMS).

Methods: A pilot study of prospective interventional cohort study was conducted from January 2021 to February 2024. Patients with unprotected LMS - left anterior descending artery with LMS distal bifurcation angle ≥90° were divided into: Group I (Medina class 1,1,0 treated with PS without FKB), Group II (Medina class 1,1,1 treated with PS) which subcategorized into two subgroups; Group IIa (PS with FKB) and Group IIb (PS without FKB). One-year follow-up outcomes were recorded.

Results: Eighty four patients were enrolled, mean age 61.16 ± 9.26 years, majority were men 68 (81%). Of the total patients, 52 (62%) patients were in Group I and 32 (38%) patients in Group II (16 patients in subgroup IIa and IIb). At one-year follow-up, 15 (65.2%) patients in group IIb did not need intervention compared with 8 (50%) patients in group IIa needed interventions. In group I, 49 (94.23) patients did not need further interventions. The highest rate for interventions for both men (50%) and women (50%) found in group IIa, followed by group I for women (20%) and IIb for men (8.3%).

Conclusions:

Performing PS without FKB for the unprotected left main coronary artery leads to better outcomes in patients with wide distal LMS bifurcation angle (≥90°). Gender disparity was identified with a higher rate of women requiring interventions in group I, while a higher rate of men required interventions in group IIb.

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.

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