Prognostic impact of final kissing balloon technique after crossover stenting for the left main coronary artery: from the AOI-LMCA registry

• Published in: Cardiovascular intervention and therapeutics 2019-07, Vol.34 (3), p.197-206
• Main Authors: Nishida, Koji, Toyofuku, Mamoru, Morimoto, Takeshi, Ohya, Masanobu, Fuku, Yasushi, Higami, Hirooki, Yamaji, Kyohei, Muranishi, Hiromi, Yamaji, Yuhei, Furukawa, Daisuke, Tada, Tomohisa, Ko, Euihong, Kadota, Kazushige, Ando, Kenji, Sakamoto, Hiroki, Tamura, Takashi, Kawai, Kazuya, Kimura, Takeshi
• Format: Article
• Language: English
• Subjects: Cardiology; Clinical Assessing Optimal Percutaneous Coronary Intervention for Left Main Coronary Artery Stenting Registry (AOI LMCA Stenting Registry). http://www.umin.ac.jp/ctr/index/htm/. Unique Identifier; Interventional Radiology; Medicine; Medicine & Public Health; Original; Original Article; UMIN000014706
• ISSN: 1868-4300; 1868-4297
• DOI: 10.1007/s12928-018-0522-0

It is still uncertain whether the final kissing balloon technique (FKBT) is mandatory after crossover stenting for the left main coronary artery (LMCA). Assessing Optimal Percutaneous Coronary Intervention for LMCA (AOI-LMCA) registry, a 6-center retrospective registry, enrolled 1809 consecutive patients for LMCA stenting in Japan. In the present analysis, 5-year clinical outcomes were compared between non-FKBT ( n  = 160) and FKBT ( n  = 578) groups in patients treated with crossover stenting with drug-eluting stents from the LMCA to the left anterior descending artery. Propensity score-matched analysis was also performed in 160 patient pairs. In the entire study population as well as in the propensity-matched population, the cumulative 5-year incidence of the primary outcome measure (target lesion revascularization: TLR) was not significantly different between the FKBT and non-FKBT groups (10.7 versus 14.3%, P  = 0.49, and 11.8 versus 14.3%, P  = 0.53, respectively). In the sensitivity analysis by the multivariable Cox proportional hazard model, the effect of FKBT relative to non-FKBT for TLR remained insignificant (adjusted HR 0.89, 95% CI 0.47–1.69, P  = 0.72). Regarding the TLR location, there were no significant differences in the cumulative incidences of TLR for LMCA-only, for the main branch, and for the side branch between the 2 groups (2.2 versus 1.3%, P  = 0.93, 11.8 versus 9.1%, P  = 0.71, and 8.2 versus 7.6%, P  = 0.82, respectively). FKBT after a 1-stent strategy for LMCA crossover stenting did not affect TLR and other clinical outcomes during 5-year follow-up. Clinical Trial Registration: Assessing Optimal Percutaneous Coronary Intervention for Left Main Coronary Artery Stenting Registry (AOI LMCA Stenting Registry). http://www.umin.ac.jp/ctr/index/htm/ . Unique Identifier: UMIN000014706.