1. Impact of Kissing Balloon in Patients Treated With Ultrathin Stents for Left Main Lesions and Bifurcations
- Author
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Leor Perl, Filippo Figini, Iván J. Núñez-Gil, Luca Gaido, Francesco Romeo, Alessandro Bernardi, Nicola Ryan, Davide Capodanno, Mauro Pennacchi, Giacomo Boccuzzi, Daniela Trabattoni, Antonio Montefusco, Javier Escaned, Maurizio D'Amico, Fabrizio Ugo, Saverio Muscoli, Pierluigi Omedè, Massimo Giammaria, Andrea Rognoni, Andrea Saglietto, Gaetano M. De Ferrari, Bernardo Cortese, Massimo Mancone, Francesco Tomassini, Ferdiando Varbella, Zenon Huczek, Enrico Cerrato, Federico Conrotto, Carlo Di Mario, Fabrizio D'Ascenzo, Wojciech Wańha, Alessio Mattesini, Leonardo De Luca, Andrea Gagnor, Francesco Burzotta, Gérard Helft, Grzegorz Smolka, Mauro Rinaldi, Radosław Parma, Francesco Bruno, Ovidio De Filippo, Imad Sheiban, Yoichi Imori, Alaide Chieffo, Giulia De Lio, and Wojciech Wojakowski
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Prosthesis Design ,Coronary Restenosis ,Coronary artery disease ,Risk Factors ,medicine ,Humans ,In patient ,Registries ,Angioplasty, Balloon, Coronary ,thrombosis ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,percutaneous coronary intervention ,drug-eluting stents ,Percutaneous coronary intervention ,Middle Aged ,medicine.disease ,Thrombosis ,Surgery ,Treatment Outcome ,Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE ,Kissing balloon ,Female ,Stents ,Cardiology and Cardiovascular Medicine ,business ,coronary artery disease - Abstract
Background: There are limited data regarding the impact of final kissing balloon (FKI) in patients treated with percutaneous coronary intervention using ultrathin stents in left main or bifurcations. Methods: All patients undergoing left main or bifurcations percutaneous coronary intervention enrolled in the RAIN registry (Very Thin Stents for Patients With MAIN or BiF in Real Life: The RAIN, a Multicenter Study) evaluating ultrathin stents were included. Major adverse cardiac event (a composite of all-cause death, myocardial infarction, target lesion revascularization, and stent thrombosis) was the primary end point, while its components, along with target vessel revascularization, were the secondary end points. The main analysis was performed comparing patients with and without FKI after adjustment with inverse probability of treatment weighting. Subgroup analyses were performed according to FKI (short [ Results: Two thousand seven hundred forty-two patients were included. At 16 months (8–20) follow-up, inverse probability of treatment weighting adjusted rates of major adverse cardiac event were similar between FKI and no-FKI group (15.1% versus 15.5%; P =0.967), this result did not change with use of imaging, proximal optimization technique, or routine versus bail-out FKI. In the 2-stent subgroup, FKI was associated with lower rates of target vessel revascularization (7.8% versus 15.9%; P =0.030) and target lesion revascularization (7.3% versus 15.2%; P =0.032). Short overlap FKI was associated with a lower rate of target lesion revascularization compared with no FKI (2.6% versus 5.4%; P =0.034), while long overlap was not (6.8% versus 5.4%; P =0.567). Conclusions: In patients with bifurcations or unprotected left main treated with ultrathin stents, short overlap FKI is associated with less restenosis. In a 2-stent strategy, FKI was associated with less target vessel revascularization and restenosis. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03544294.
- Published
- 2020