Is Left main angulation really a predictor of mortality for Left Main

Is Left main angulation really a predictor of mortality for Left Main

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European Bifurcation Club 2009 – EBC 2009 – Berlin, Germany

Bifurcation angles: infuence on bifurcation stenting indication?

Is Left main angulation really a predictor of mortality for Left Main

Author: Chrysafios Girasis, MD, Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands

 

CONCLUSION

  • First exclusively 3D QCA, blinded analysis did not find a relation between the pre-PCI LM distal BA and 1-yr outcome measures (MACCE/mortality)
  • There was a trend however for the subgroup of cases where ≥2 stents were deployed in the LM bifurcation; the steeper the angle the worse the outcome
  • 3D bifurcation angle analysis is not always feasible
  • Analysis of either diastolic or systolic values is reasonable. However cut-off values are different
  • Distal BA values, pre PCI, have an impact on very long-term outcome measures. The larger the angle, the worse the outcome.
  • After adjustment for demographics, risk factors, indication, type of stent and angiographic characteristics these effects remain apparent but largely non- significant except for p-MACE
  • Dilution of effect due to 2D QCA?
  • New studies with increased power/population are necessary

 

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