TY - JOUR
T1 - Impact of Kissing Balloon in Patients Treated with Ultrathin Stents for Left Main Lesions and Bifurcations: An Analysis from the RAIN-CARDIOGROUP VII Study
AU - Gaido, Luca
AU - D'Ascenzo, Fabrizio
AU - D'Ascenzo, Francesca
AU - Imori, Yoichi
AU - Wojakowski, Wojciech
AU - Saglietto, Andrea
AU - Figini, Filippo
AU - Mattesini, Alessio
AU - Trabattoni, Daniela
AU - Rognoni, Andrea
AU - Tomassini, Francesco
AU - Bernardi, Alessandro
AU - Ryan, Nicola
AU - Muscoli, Saverio
AU - Helft, Gerard
AU - De Filippo, Ovidio
AU - Parma, Radoslaw
AU - De Luca, Leonardo
AU - Ugo, Fabrizio
AU - Cerrato, Enrico
AU - Montefusco, Antonio
AU - Pennacchi, Mauro
AU - Wańha, Wojciech
AU - Smolka, Grzegorz
AU - De Lio, Giulia
AU - Bruno, Francesco
AU - Huczek, Zenon
AU - Boccuzzi, Giacomo
AU - Cortese, Bernardo
AU - Capodanno, Davide
AU - Omedè, Pierluigi
AU - Mancone, Massimo
AU - Nuñez-Gil, Ivan
AU - Romeo, Francesco
AU - Romeo, Fabio
AU - Varbella, Ferdiando
AU - Rinaldi, Mauro
AU - Escaned, Javier
AU - Conrotto, Federico
AU - Burzotta, Francesco
AU - Chieffo, Alaide
AU - Perl, Leor
AU - D'Amico, Maurizio
AU - Di Mario, Carlo
AU - Di Mario, Clara
AU - Sheiban, Imad
AU - Gagnor, Andrea
AU - Giammaria, Massimo
AU - De Ferrari, Gaetano Maria
PY - 2020
Y1 - 2020
N2 - 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 [<3 mm] versus long overlap), strategy (provisional versus 2-stent), routine versus bail-out FKI, and the use of imaging and proximal optimization technique. 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.
AB - 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 [<3 mm] versus long overlap), strategy (provisional versus 2-stent), routine versus bail-out FKI, and the use of imaging and proximal optimization technique. 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.
KW - coronary artery disease
KW - drug-eluting stents
KW - percutaneous coronary intervention
KW - thrombosis
KW - coronary artery disease
KW - drug-eluting stents
KW - percutaneous coronary intervention
KW - thrombosis
UR - http://hdl.handle.net/10807/158777
U2 - 10.1161/CIRCINTERVENTIONS.119.008325
DO - 10.1161/CIRCINTERVENTIONS.119.008325
M3 - Article
SN - 1941-7640
VL - 13
SP - e008325-N/A
JO - Circulation: Cardiovascular Interventions
JF - Circulation: Cardiovascular Interventions
ER -