ABSTRACT
Background: There are limited number of studies in India which have looked at this clinical and angiographic characteristic of the disease. Thus, this study was conducted to assess the clinical and angiographic profile of symptomatic patients who underwent percutaneous transluminal coronary angioplasty (PTCA) and drug-eluting stent (DES) implantation.Methods: This was an observational study conducted at a tertiary-care center in India between November 2014 and November 2015. A total of 106 consecutive patients who received either Cypher/Xience/BioMime stent presented with anginal symptoms were included in the study. Based on the type of stent received, patients were divided into two groups: (A) Limus group; (B) Paclitaxel group. Coronary angiogram was done in all the patients. Angioplasty data were collected from patient records. Angiographic profiles of the two groups were compared and analysed.Results: Among the 106 patients, 54 patients were included in the Limus group and 52 patients were included in the Taxus stent. De novo lesions were found to be significantly higher in the Limus group (40(74%), p = 0.06) whereas the in-stent restenosis was found to be significantly higher in the paclitaxel group (22(42.3%), p = 0.08). At follow-up, the incidence of death was 0% and no patients suffered by myocardial infarction. One (1.8%), two (3.8%) patients from the Limus and Paclitaxel groups had target vessel revascularization, respectively.Conclusions: Development of lesions in new areas rather than in-stent restenosis is the cause for angina in the majority of patients who underwent angioplasty presenting with anginal symptoms.
ABSTRACT
Background: The aim of this study was to analyze angiographic parameters such as bifurcation angle, diameter at the polygon of confluence (POC) and SYNTAX score in predicting the need for side branch treatment with single-stent crossover technique from distal unprotected left main coronary artery (ULMCA) to the major side branch.Methods: This was a retrospective and observational study. A total of 83 patients with distal ULMCA lesions were enrolled. Patients who underwent provisional single-stent crossover technique were compared with patients that required side branch treatment though plain old balloon angioplasty (POBA) 5 (6.0%) or stenting 7 (8.4%). Angiographic parameters, bifurcation angle, diameter at the POC and the SYNTAX score were analyzed for their ability to predict the need for side branch treatment.Results: Mean age of patients was 58.2±5.3 years. Males constituted 61 (73.5%) patients. Post main branch stenting 5 (6.0%) and 7 (8.4%) patients required side branch treatment with POBA and stent implantation, respectively. Binary regression revealed bifurcation angle (Z: 1.15, OR: 0.99, 95% CI: 0.97-1.01, p=0.25), diameter at the POC (Z: 1.1, OR: 0.82, 95% CI: 0.32-2.13, p=0.272) and SYNTAX score (Z: 1.51, OR: 1.18, 95% CI: 0.95-1.45, p=0.132) did not correctly predict the requirement of side branch treatment.Conclusion: Left main coronary artery to main branch stenting can be performed safely with single-stent crossover technique, irrespective of presence of side branch disease across a wide range of bifurcation angles, diameters at the POC and SYNTAX scores.