Research Article

Clinical Implications of Bifurcation Angles in Left Main Bifurcation Intervention Using a Two-Stent Technique

Table 3

Angiographic and procedural characteristics in patients treated with the 2-stent technique using the crush technique or T-stenting in LM Bifurcation.

CrushT-stenting
LM-LAD angle ≥152° (n = 84)LM-LAD angle <152° (n = 96) valueLM-LAD angle ≥152° (n = 93)LM-LAD angle <152° (n = 71) value

Angle of LM-LAD166.4 (158.5–175.1)134.0 (120.5–143.2)<0.001165.0 (157.6–173.3)136.1 (125.0–142.0)<0.001
Angle of LM-LCX116.2 (104.1–131.8)125.5 (108.7–143.0)0.009120.1 (104.0–132.7)121.0 (107.0–137.0)0.495
Angle of LAD-LCX68.3 (55.8–86.7)94.5 (79.5–116.5)<0.00171.9 (60.4–85.1)96.0 (76.1–109.8)<0.001
SYNTAX Score0.9720.690
Low score (0–22)27 (32.1)31 (32.2)32 (34.8)28 (40.0)
Intermediate score (23–32)33 (39.3)39 (40.6)47 (51.1)31 (44.3)
High score (≥33)24 (28.6)26 (27.1)13 (14.1)11 (15.7)
Medina Classification0.6030.475
True bifurcation
1.1.138 (45.2)38 (39.6)42 (45.2)42 (59.2)
1.0.110 (11.9)11 (11.5)7 (7.5)5 (7.0)
0.1.19 (10.7)13 (13.5)18 (19.4)9 (12.7)
Nontrue bifurcation
1.0.02 (2.4)2 (2.1)2 (2.2)2 (2.8)
0.1.06 (7.1)10 (10.4)7 (7.5)3 (4.2)
1.1.05 (6.0)12 (12.5)12 (12.9)8 (11.3)
0.0.114 (16.7)10 (10.4)5 (5.4)1 (1.4)
DES Type0.6090.775
SES40 (47.6)41 (42.7)43 (46.2)27 (38.0)
PES18 (21.4)15 (15.6)15 (16.1)15 (21.1)
ZES9 (10.7)16 (16.7)13 (14.3)9 (12.7)
EES15 (17.9)19 (19.8)15 (16.1)14 (19.7)
BP-BES0 (0)1 (1.0)6 (6.5)6 (8.5)
Stent Type0.2670.442
First generation DES60 (71.4)60 (62.5)63 (67.7)44 (62.0)
Second generation DES24 (28.6)36 (37.5)30 (32.3)27 (38.0)
LAD stent diameter3.4 ± 0.43.5 ± 0.40.4083.4 ± 0.43.4 ± 0.40.655
LCX stent diameter3.0 ± 0.33.0 ± 0.30.9903.2 ± 0.53.2 ± 0.40.410
IVUS-guided PCI53 (63.1)53 (55.2)0.29366 (71.0)49 (69.0)0.787
Rotablation0 (0)1 (1.0)1.0001 (1.1)1 (1.4)1.000
Final kissing ballooning65 (83.3)73 (83.0)0.94873 (90.1)60 (96.8)0.187
Conversion from provisional stenting0/76 (0)3/75 (4.0)0.12060/79 (75.9)47/53 (88.7)0.067
Main vessel procedural success84/84 (100.0)95/96 (99.0)1.00093/93 (100.0)70/70 (100.0)NA
Side branch procedural success84/84 (100.0)95/96 (99.0)1.00093/93 (100.0)68/70 (97.1)0.183
Preintervention QCA
MV RD, mm3.2 ± 0.43.2 ± 0.50.6023.3 ± 0.53.2 ± 0.60.718
SB RD, mm2.6 ± 0.42.7 ± 0.40.2622.9 ± 0.52.7 ± 0.60.114
MV MLD, mm1.2 ± 0.61.2 ± 0.60.7191.2 ± 0.61.1 ± 0.50.324
SB MLD, mm1.2 ± 0.61.1 ± 0.60.5721.3 ± 0.61.1 ± 0.50.055
MV diameter stenosis, %62.1 ± 17.264.4 ± 16.00.35962.2 ± 18.164.8 ± 17.80.354
SB diameter stenosis, %56.2 ± 20.559.4 ± 20.50.30654.1 ± 19.458.5 ± 18.40.161
MV lesion length, mm21.5 ± 17.525.4 ± 20.30.17520.4 ± 14.020.1 ± 14.90.911
SB lesion length, mm12.8 ± 11.412.6 ± 11.80.9199.9 ± 10.411.9 ± 12.30.260
MV calcification22 (26.2)42 (43.8)0.01936 (38.7)28 (40.0)0.867
SB calcification15 (17.9)21 (21.9)0.57721 (22.6)14 (20.0)0.671
Postintervention QCA
MV RD, mm3.2 ± 0.53.2 ± 0.60.8063.5 ± 0.63.3 ± 0.60.167
SB RD, mm2.7 ± 0.52.7 ± 0.50.7532.9 ± 0.52.8 ± 0.50.214
MV MLD, mm2.8 ± 0.52.7 ± 0.50.4922.7 ± 0.52.9 ± 0.60.521
SB MLD, mm2.5 ± 0.52.5 ± 0.50.4162.7 ± 0.62.6 ± 0.50.292
MV diameter stenosis, %14.6 ± 11.516.3 ± 11.80.38715.3 ± 11.414.7 ± 9.70.765
SB diameter stenosis, %6.2 ± 17.87.9 ± 14.70.5379.1 ± 13.88.3 ± 12.60.735

Values are mean ± standard deviations, median (interquartile ranges, 25th–75th), or n (%) (per-patient analysis). BP-BES, biodegradable polymer biolimus-eluting stent; DES, drug-eluting stent; EES, everolimus-eluting stent; IVUS, intravascular ultrasound; LAD, left anterior descending artery; LCX, left circumflex artery; LM, left main; MLD, minimal lumen diameter; MV, main vessel; PCI, percutaneous coronary intervention; PES, paclitaxel-eluting stent; QCA, quantitative coronary angiography; RD, reference diameter; SB, side branch; SES, sirolimus-eluting stent; ZES, zotarolimus-eluting stent.