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Feasibility, safety and long-term outcomes of complex left main bifurcation treatment using the nano-inverted-t stenting: a multicentre prospective registry

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Abstract

The role of double stenting techniques in distal bifurcation left main (LM) disease has gaining interest over the latest years. We present the 3-year multicentre registry outcomes of dual stenting using ultra-thin strut stents and the Nano-Inverted-T (NIT) technique in complex unprotected true LM bifurcation disease. We analysed the procedural and medical data of consecutive patients enrolled between 1st January 2014 and 1st December 2019 in a multicentre registry for complex LM bifurcation disease treated with the double stenting technique called NIT due contraindications and/ or refusal to surgical treatment. Target lesion failure (TLF) was defined as the composite of cardiovascular death, target-vessel MI (TVMI) and clinically driven target lesion revascularization (TLR). Among two hundred-ninety-five patients (138 males, mean age 70.3 ± 12.8 years), post-operative success was achieved in 100% of cases. Contrast volume, procedural time, and radiation exposure were 139.2 ± 23.4 ml, 15.3 ± 4.9 min, and 1080 ± 1034 cGy/m2, respectively. At a mean follow-up of 39.5 ± 0.6 months TLF rate was 6.1% (n = 18) while TLR and cardiovascular mortality rates were 3.0 (n = 9) and 2.6% (n = 8), respectively. Clinically-driven angiographic follow-up was available in 26.4% of patients at a mean time from the procedure of 7.5 ± 0.4 months. Clinically restenosis rate was 3.3%.

Revascularization of complex LM bifurcation disease using the NIT double stenting technique resulted feasible and safe with a low incidence of TLF, excellent survival rate and no stent thrombosis.

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Abbreviations

AMI:

Acute myocardial infarction

CCS:

Canadian cardiovascular score class

EBC:

European bifurcation club

DK:

Double-kissing

ISR:

In-stent restenosis

LM:

Left main

NIT:

Nano-inverted T

PCI:

Percutaneuos coronary intervention

STEMI:

ST-elevation myocardial infarction

TLF:

Target lesion failure

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Authors and Affiliations

  1. Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, Viale Tre Martiri 140, 45100, Rovigo, Italy

    Gianluca Rigatelli, Marco Zuin & Fabio Dell’Avvocata

  2. School of Medicine, University of Ferrara, Ferrara, Italy

    Marco Zuin

  3. Head of Cardiology, Alexandroska University Hospital Medical School, Sofia, Bulgaria

    Dobrin Vassilev

  4. Department of Interventional Cardiology, Tam Duc Heart Hospital, Ho Chi Minh City, Vietnam

    Huy Dinh

  5. Department of Interventional Cardiology, Thong Nhat Hospital, Ho Chi Minh City, Vietnam

    Nguyen Van Tan

  6. Department of Interventional Cardiology, Cho Ray Hospital, Ho Chi Minh City, Vietnam

    Nguyen Nghia

  7. Interventional Cardiology Unit, Department of Cardiology, Mestre Hospital, Mestre, Italy

    Federico Ronco

  8. Division of Cardiology, Rovigo General Hospital, Rovigo, Italy

    Loris Roncon

Authors
  1. Gianluca Rigatelli
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  2. Marco Zuin
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  8. Federico Ronco
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Correspondence to Gianluca Rigatelli.

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Rigatelli, G., Zuin, M., Vassilev, D. et al. Feasibility, safety and long-term outcomes of complex left main bifurcation treatment using the nano-inverted-t stenting: a multicentre prospective registry. Int J Cardiovasc Imaging 37, 1107–1119 (2021). https://doi.org/10.1007/s10554-020-02106-x

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