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. 2023 Apr 16;13(4):670.
doi: 10.3390/jpm13040670.

Unprotected Left Main Bifurcation Stenting in Acute Coronary Syndromes: Two-Stent Technique versus One-Stent Technique

Lucian Predescu  1   2 , Marin Postu  1 , Lucian Zarma  1 , Adrian Bucsa  1 , Pavel Platon  1   2 , Marian Croitoru  1 , Adrian Mereuta  1   2 , Leonard Licheardopol  3 , Alexandra Predescu  4 , Dan Dorobantu  1   5 , Dan Deleanu  1
Affiliations

Unprotected Left Main Bifurcation Stenting in Acute Coronary Syndromes: Two-Stent Technique versus One-Stent Technique

Lucian Predescu et al. J Pers Med. .

Abstract

Aims: There is little evidence guiding the choice between a one-stent and a two-stent approach in unprotected distal left main coronary artery disease (UDLMCAD) presenting as acute coronary syndrome (ACS). We aim to compare these two techniques in an unselected ACS group.

Methods and results: We conducted a single center retrospective observational study, that included all patients with UDLMCAD and ACS undergoing PCI between 2014 and 2018. Group A underwent PCI with a one-stent technique (n = 41, 58.6%), Group B with a two-stent technique (n = 29, 41.4%). A total of 70 patients were included, with a median age of 63 years, including n = 12 (17.1%) with cardiogenic shock. There were no differences between Group A and B in terms of patient characteristics, including SYNTAX score (median 23). The 30-day mortality was 15.7% overall, and was lower in Group B (3.5% vs. 24.4%, p = 0.02). Mortality rate at 4 years was significantly lower in Group B (21.4% vs. 44%), also when adjusted in a multivariable regression model (HR 0.26, p = 0.01).

Conclusions: In our study, patients with UDLMCAD and ACS undergoing PCI using a two-stent technique had lower early and midterm mortality compared to one-stent approach, even after adjusting for patient-related or angiographic factors.

Keywords: acute coronary syndrome; left main coronary lesion; two-stent technique.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Unadjusted comparisons of mortality, TLR and MACE at 4 years according to the stent strategy in patients with unprotected left main coronary artery disease and acute coronary syndrome (Group A—one-stent strategy; Group B—two-stent strategy). Curves represent Kaplan–Meier failure function. TLR—target lesion revascularization; MACE—major adverse cardiac event.
See this image and copyright information in PMC

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