Author + information
- Akiko Fujino,
- Akiko Maehara,
- Gary Mintz,
- Adrian Banning,
- Béla Merkely,
- Imre Ungi,
- Ad J. van Boven,
- Manu Prabhakar,
- Zixuan Zhang,
- Arie Pieter Kappetein,
- Joseph F. Sabik,
- Patrick W. Serruys and
- Gregg Stone
A small minimum stent area (MSA) after left main (LM) PCI has been associated with poor clinical outcomes. The predictors of (LM) stent MSA have not been described.
EXCEL was a multicenter, randomized trial comparing PCI with everolimus-eluting stents (n=948) to CABG (n=957) in pts with LM disease. Among PCI pts with both pre- and post-PCI intravascular ultrasound (IVUS, n=290), baseline IVUS findings predicting final MSA were identified.
The post-PCI median MSA in the LM was 10.3 mm2. Pre-PCI IVUS characteristics associated with a MSA less than the median included small vessel and lumen dimensions, greater plaque % volume, large superficial calcium arc and length, and ostial or body LM lesion location (Table). In a multivariable linear regression model, only smaller vessel area (p<0.01) and greater calcium angle (p<0.01) were associated with smaller MSA. MSA predictors were similar when the analysis was confined to distal bifurcation lesions. Female sex and ostial or body LM lesion location correlated with a smaller pre-PCI LM vessel area (both p<0.01).
Small LM stent MSA after PCI with EES is predicted by small LM vessel size and greater baseline arc of superficial calcium. Female sex and ostial or body LM lesion location were associated with small vessel size, explaining their relationship with small post-PCI LM stent dimensions.
Poster Hall, Hall A/B
Monday, March 12, 2018, 9:45 a.m.-10:30 a.m.
Session Title: Left Main, Multivessel, Bifurcation Lesions: Role of Invasive and Non-Invasive Assessments
Abstract Category: 22. Interventional Cardiology: Coronary Intervention: Left Main, Multivessel, Bifurcation
Presentation Number: 1292-310
- 2018 American College of Cardiology Foundation