title: Clinical and angiographic outcomes after drug-eluting stent implantation with triple-kissing-balloon technique for left main trifurcation lesion: comparison of single-stent and multi-stent procedures.
abstract: OBJECTIVE
  This study evaluated clinical and angiographic outcomes after drug-eluting stent (DES) implantation with triple-kissing-balloon technique (triple-KBT) for left main (LM) trifurcation lesions and compared them between single-stent and multi-stent procedures.
  
  
  BACKGROUND
  The triple-KBT is a challenging strategy to treat LM trifurcation lesions with both single-stent and multi-stent procedures, and its outcomes after DES implantation were unknown.
  
  
  METHODS
  We evaluated 72 patients who underwent triple-KBT after DES implantation for LM trifurcation lesions from April 2005 to October 2012, and compared the clinical and angiographic outcomes between 45 patients in the single-stent group and 27 patients in the multi-stent group. Patients with 2 or 3 stents implanted were included in the multi-stent group.
  
  
  RESULTS
  Procedural success was obtained in 93.1% of all patients, with no in-hospital death, myocardial infarction, and target lesion revascularization (TLR). The median follow-up duration was 838 days. The incidence of all-cause death at 3 years was 8.6%, and there was no significant difference between the single-stent and multi-stent groups (8.0% vs. 9.7%; P=.82). There were no patients with myocardial infarction or stent thrombosis. The incidence of TLR at 3 years was 14.5%, and it was significantly higher in the multi-stent group (31.3%) than in the single-stent group (4.6%; P=.01). No incidence of TLR was observed beyond 1 year in both groups.
  
  
  CONCLUSIONS
  DES implantation with triple-KBT was a safe and feasible technique for LM trifurcation lesion. The favorable clinical outcomes could be achieved by single-stent procedure compared with multi-stent procedure.
authors.affiliation: Department of Cardiology, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki 710-8602, Japan. daba-kuboshun101@hotmail.co.jp.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Kubo
authors.forename: Kazushige
authors.initials: K
authors.lastname: Kadota
authors.forename: Mahmoud
authors.initials: M
authors.lastname: Sabbah
authors.forename: Suguru
authors.initials: S
authors.lastname: Otsuru
authors.forename: Daiji
authors.initials: D
authors.lastname: Hasegawa
authors.forename: Seiji
authors.initials: S
authors.lastname: Habara
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tada
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tanaka
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Fuku
authors.forename: Harumi
authors.initials: H
authors.lastname: Katoh
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Goto
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Mitsudo
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation* / Q000379:methods*; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy*; D016757:Death, Sudden, Cardiac; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015996:Survival Rate