title: Differences of side branch jailing between left main-left anterior descending artery stenting and left main-left circumflex artery stenting with Nobori biolimus-eluting stent.
abstract: The aim of this study is to indicate differences of side branch jailing between the left main (LM)-left anterior descending artery (LAD) stenting and the LM-left circumflex artery (LCx) stenting. Thirty-one patients who underwent single-stenting using a two-link ten-crowns biolimus-eluting stent (Japanese design of BES, J-BES) and subsequent kissing balloon dilation (KBD) on an LM bifurcation with optical coherence tomography (OCT) were divided into two groups according to the stented vessel. Bifurcation angles were measured by three-dimensional (3D) quantitative coronary analysis. The jailing pattern on a side branch ostium was evaluated by stent-enhanced 3D-OCT. Incomplete stent apposition (ISA) after KBD was compared between the stented vessels. The to-be-stented angle of the LM-LCx stenting (n = 11) was significantly steeper than that of the LM-LAD stenting (n = 20) (132.6° ± 16.9° vs. 150.7° ± 10.6°, p < 0.01). The incidence of the free carina type, which has no stent links bridging from a carina, in the LM-LCx stenting was significantly higher than that in the LM-LAD stenting (90.9 vs. 45.0 %, p = 0.02). The percentage of ISA at the bifurcation segment in the LM-LCx stenting was significantly smaller than that in the LM-LAD stenting (4.4 ± 8.2 vs. 12.7 ± 9.2 %, p = 0.0003). This study showed, by higher incidence of the favorable configuration, that the LM-LCx stenting achieved a smaller percentage of ISA than the LM-LAD stenting. These insights may help guide LM bifurcation stenting with J-BES.
authors.affiliation: Department of Cardiology, Yamaguchi Grand Medical Center, 77 Ohsaki, Hofu, Yamaguchi, 747-8511, Japan. nakao-ymghp@umin.ac.jp.
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Nakao
authors.affiliation: Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-kogushi, Ube, Yamaguchi, 755-8505, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Okamura
authors.affiliation: Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-kogushi, Ube, Yamaguchi, 755-8505, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Suetomi
authors.affiliation: Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-kogushi, Ube, Yamaguchi, 755-8505, Japan.
authors.forename: Jutaro
authors.initials: J
authors.lastname: Yamada
authors.affiliation: Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-kogushi, Ube, Yamaguchi, 755-8505, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nakamura
authors.affiliation: Department of Cardiology, Yamaguchi Grand Medical Center, 77 Ohsaki, Hofu, Yamaguchi, 747-8511, Japan.
authors.forename: Tooru
authors.initials: T
authors.lastname: Ueda
authors.affiliation: Department of Cardiology, Yamaguchi Grand Medical Center, 77 Ohsaki, Hofu, Yamaguchi, 747-8511, Japan.
authors.forename: Takamasa
authors.initials: T
authors.lastname: Oda
authors.affiliation: Department of Cardiology, Yamaguchi Grand Medical Center, 77 Ohsaki, Hofu, Yamaguchi, 747-8511, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Kanemoto
authors.affiliation: Department of Cardiology, Yamaguchi Grand Medical Center, 77 Ohsaki, Hofu, Yamaguchi, 747-8511, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ikeda
authors.affiliation: Department of Cardiology, Yamaguchi Grand Medical Center, 77 Ohsaki, Hofu, Yamaguchi, 747-8511, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Fujii
authors.affiliation: Division of Cardiology, Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, 1-1-1 Minami-kogushi, Ube, Yamaguchi, 755-8505, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Yano
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation*; D002317:Cardiovascular Agents / Q000008:administration & dosage* / Q000009:adverse effects; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007564:Japan; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies; D020123:Sirolimus / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents; C518022:umirolimus; D020123:Sirolimus
keywords: Biolimus-eluting stent; Coronary bifurcation; Left main disease; Optical coherence tomography