One Versus Two Stents Strategies for Unprotected Left Main Intervention: Gulf Left Main Registry

• Published in: Angiology Vol. 74; no. 8; p. 754
• Main Authors: Alasmari, Abdulaziz, Iskandar, Mina, Daoulah, Amin, Hersi, Ahmad S, Alshehri, Mohammed, Aljohar, Alwaleed, Al Garni, Turki, Abuelatta, Reda, Yousif, Nooraldaem, Almahmeed, Wael, Kazim, Hameedullah M, Refaat, Wael, Selim, Ehab, Alzahrani, Badr, Alqahtani, Abdulrahman H, Ajaz Ghani, Mohamed, Amin, Haitham, Hashmani, Shahrukh, El-Sayed, Osama, Jamjoom, Ahmed, Hurley, William T, Dahdouh, Ziad, Aithal, Jairam, Ahmad, Osama, Ramadan, Mohamed, Ibrahim, Ahmed M, Elganady, Abdelmaksoud, Qutub, Mohammed A, Alama, Mohamed N, Abohasan, Abdulwali, Hassan, Taher, Balghith, Mohammed, Altnji, Issam, Hussien, Adnan Fathey, Abdulhabeeb, Ibrahim A M, Qenawi, Wael, Shawky, Ahmed, Ghonim, Ahmed A, Elmahrouk, Ahmed, Hiremath, Niranjan, Jameel Naser, Maryam, Shawky, Abeer M, Lotfi, Amir
• Format: Journal Article
• Language: English
• Published: United States 01.09.2023
• Subjects: Coronary Artery Disease - therapy; Drug-Eluting Stents; Humans; Percutaneous Coronary Intervention - adverse effects; Registries; Retrospective Studies; Stents; Treatment Outcome; Gulf left main registry; percutaneous coronary intervention; 2-stent; unprotected left main coronary artery; outcomes; 1-stent; Gulf region
• DOI: 10.1177/00033197221121004

The optimal stenting strategy for unprotected left main coronary artery (ULMCA) disease remains debated. This retrospective observational study (Gulf Left Main Registry) analyzed the outcomes of 1 vs 2 stents in patients with unprotected left main percutaneous coronary intervention (PCI). Overall, 1222 patients were evaluated; 173 had 1 stent and 1049 had 2 stents. The 2-stent group was older with more comorbidities, higher mean SYNTAX scores, and more distal bifurcation lesions. In the 1-stent group, in-hospital events were significant for major bleeding, and better mean creatinine clearance. At median follow-up of 20 months, the 1-stent group was more likely to have target lesion revascularization (TLR). Total mortality was numerically lower in the 1-stent group (.00% vs 2.10%); however, this was not statistically significant ( =.068). Our analysis demonstrates the benefits of a 2-stent approach for ULMCA patients with high SYNTAX scores and lesions in both major side branches, while the potential benefit of a 1-stent approach for less complex ULMCA was also observed. Further studies with longer follow-up are needed to definitively demonstrate the optimal approach.