Drug-eluting stent implantation in coronary trifurcation lesions.
BACKGROUND
There is no specific study evaluating the outcome of DES implantation in trifurcation lesions.


OBJECTIVE
To evaluate the mid-term clinical and angiographic outcome of drug-eluting stent (DES) implantation in trifurcation lesions.


METHODS
All complications and major adverse cardiac events, including cardiac death, Q-wave myocardial infarction (MI), target lesion revascularization (TLR), and target vessel revascularization (TVR) were recorded in-hospital and during clinical follow up.


RESULTS
A total of 15 consecutive patients undergoing percutaneous coronary intervention with DES in de novo trifurcation lesions were identified. Lesions were located as follows: 13 (86.7%) at the distal left main coronary artery (LMCA) comprising the left anterior descending artery (LAD), the left circumflex artery (LCX) and an intermediate branch; 1 between the LAD, diagonal, and septal branches; and 1 between the LCX, obtuse marginal and posterior lateral branches. Stenting was performed in all 3 branches in 8 patients, in 2 branches in 6 patients, and in 1 branch in 1 patient. The mean follow-up period was 19.0 +/- 8.3 months. TLR occurred in 3 patients (20%) with LMCA lesions. TVR occurred in 6 patients (40%). Of those, 3 were due to TLR, while the other 3 for progression of nontarget lesions. No deaths, Q-wave MIs or stent thromboses were recorded.


CONCLUSIONS
Most trifurcation lesions were found in the distal LMCA. DES implantation in trifurcation lesions can be performed with a low incidence of death, Q-wave MI or stent thrombosis.
Furuichi
Shinichi
S
San Raffaele Scientific Institute and EMO Centro Cuore Columbus, Milan, Italy.
Sangiorgi
Giuseppe M
GM
Palloshi
Altin
A
Godino
Cosmo
C
Airoldi
Flavio
F
Montorfano
Matteo
M
Chieffo
Alaide
A
Michev
Iassen
I
Carlino
Mauro
M
Colombo
Antonio
A
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D023903:Coronary Restenosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D019919:Prosthesis Implantation / Q000379:methods*; D015607:Stents
D007166:Immunosuppressive Agents