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Predictors of Outcome after the Treatment of DES restenosis in the Distal UPLM (MITO)

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European Bifurcation Club 2012 – EBC 2012 – Castelldefels, Spain

Restenosis: how to treat? Cases: left main, non left main

Predictors of Outcome after the Treatment of DES restenosis in the Distal UPLM (MITO)

Author: Sunao Nakamura MD,

 

BACKGROUND

  • Aside from the use of DES, there is no consensual agreement regarding the optimal PCI strategy for ULM stenosis, particularly when the distal bifurcation is involved. Moreover, there is little data available on the treatment of ISR in this region.
  • The aim of this study was to evaluate the optimal PCI strategy for patients with UDLM DES-ISR, and to determine whether the initial strategy impacts upon the outcome of TLR for the ISR.

CONCLUSION

  • This study suggests that patients with DES-ISR in theUDLM derive greater benefit from further DES implantation than from POBA even if the restenosis is focal.
  • Complex lesions requiring a 2-SS were associated with a higher risk of initial DES-ISR as well as recurrent DES-ISR in the region of the LCx ostium following TLR. .
  • Given that the majority of patients with focal DES-ISR at the ostium of the LCx are asymptomatic, it remains to be seen whether these lesions, often found at follow-up angiography, should be treated.

 

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