title: Comparison between one-stent versus two-stent technique for treatment of left main bifurcation lesions: A large single-center data.
abstract: BACKGROUND
  Comparisons between one- and two-stent strategies for unprotected left main (UPLM) coronary bifurcation disease have yielded inconsistent results. This large-sample, long-term follow-up study comparatively assessed stenting strategy impact in patients with distal left main disease.
  
  
  METHODS
  Totally, 1,528 consecutive patients underwent left main percutaneous coronary intervention in a single center from January 2004 to December 2010 were enrolled; among them, 1033 patients with distal UPLM lesions treated by one (n = 661) or two (n = 372) drug-eluting stent (DES) technique were comparatively analyzed. Primary outcome was rate of major adverse cardiovascular events (MACE), defined as a composite of death, myocardial infarction (MI), and target vessel revascularization (TVR).
  
  
  RESULTS
  Overall, baseline SYNTAX score was low-intermediate (one stent: 25 ± 6 vs. two stents: 26 ± 5, P = 0.02), and mean clinical SYNTAX score was similar between groups (one stent: 30 ± 22 vs. two stents: 31 ± 22, P = 0.47). Final kissing balloon was successfully achieved in most of the patients treated with two-stent technique (one stent: 30.9% vs. two stents: 96.0%, P < 0.01), and use of intravascular ultrasound was also more common in them (one stent: 32.2% vs. two stents: 53.8%, P < 0.01). At mean 4 years follow-up, rates of MACE (one stent: 9.2% vs. two stents: 11.6%, P = 0.23), death, MI, and TVR were similar between groups. In multivariate propensity-matched regression analysis, two-stent technique was not predictive of MACE.
  
  
  CONCLUSIONS
  For patients with distal UPLM disease and low-intermediate SYNTAX score treated with DES, clinical outcomes appear similar between optimal two-stent implantation and one-stent strategy. © 2015 Wiley Periodicals, Inc.
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Zhan
authors.initials: Z
authors.lastname: Gao
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Xu
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Yuejin
authors.initials: Y
authors.lastname: Yang
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Shubin
authors.initials: S
authors.lastname: Qiao
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Yongjian
authors.initials: Y
authors.lastname: Wu
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Chen
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Xu
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Jinqing
authors.initials: J
authors.lastname: Yuan
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Jue
authors.initials: J
authors.lastname: Chen
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China.
authors.forename: Run-lin
authors.initials: RL
authors.lastname: Gao
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods / Q000401:mortality; D016009:Chi-Square Distribution; D002681:China; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000209:etiology; D057216:Propensity Score; D011474:Prosthesis Design; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
keywords: bifurcation; drug-eluting stents; percutaneous coronary angioplasty; unprotected left main