The objective of the study is to investigate clinical outcomes following single versus dual stenting strategies for the treatment of true bifurcation distal left main coronary artery lesions.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
450
Stenting of main vessel should be undertaken with a wire jailed in the side vessel to preserve side vessel flow and access. Stent diameter should be chosen according to diameter of the main vessel immediately distal to the bifurcation. Distal left main should be dilated with a short non-compliant balloon. Side vessel should be rewired and a kissing balloon inflation should be undertaken. Balloon sizes should be according to the diameter of the main and side vessel with individual high pressure inflation followed by a final lower pressure kiss dilatation. Proximal stented portion in the left main coronary artery should be dilated to full expansion using either low pressure dilatation of the kissing balloon pair or a separate individual balloon. It is preferred that non-compliant balloons should be used to limit overstretching of vessels. In case of specific situations described in the protocol the operator may choose to implant a side vessel stent, using same process as described above.
Coronary guide wires should be passed to LAD and Cx/intermediate arteries respectively. One should be designated the main vessel and one should be designated the side vessel. The planned dual stent technique is at the discretion of the operator but should be one of culotte, minicrush, T or TAP. If a crush procedure is chosen, it should ideally be of the DK variety. Stent diameter should be chosen according to the diameter of the vessel immediately distal to the bifurcation. Wire jail, POT, non-compliant balloons, high pressure individual "ostial" dilatations and final dilatation of the stented proximal left main should be used in accordance with the advice of the EBC. Further treatment to proximal or distal aspects of the main vessel or side vessel can be continued at the discretion of the operator. At any stage, proximal or distal dissections may be treated as required with further stent implantations. At any stage, post-dilatations may be undertaken to optimise stent expansion.
Aarhus University Hospital
Aarhus, Denmark
Composite of Death, Myocardial infarction and Target Lesion Revascularisation
Time frame: 1 year
Death
Time frame: 1 year
Myocardial Infarction
Time frame: 1 year
Target Lesion Revascularization
Time frame: 1 year
Angina status
Time frame: 1 year
Stent thrombosis
Time frame: 1 year
Death
Time frame: 3 years
Myocardial Infarction
Time frame: 3 years
Target Lesion Revascularization
Time frame: 3 years
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.
Rigshospitalet Copenhagen University Hospital
Copenhagen, Denmark
ACTIVE_NOT_RECRUITINGClinique de Fontaine
Fontaine-lès-Dijon, France
NOT_YET_RECRUITINGHCL CHU Luis Pradel
Lyon, France
NOT_YET_RECRUITINGHopital Jacques Cartier
Massy, France
NOT_YET_RECRUITINGClinique Saint Hilaire
Rouen, France
NOT_YET_RECRUITINGClinique Pasteur
Toulouse, France
NOT_YET_RECRUITINGCHU Rangueil
Toulouse, France
NOT_YET_RECRUITINGHerzzentrum Bad Krozingen
Bad Krozingen, Germany
NOT_YET_RECRUITINGElisabeth Krankenhaus Essen
Essen, Germany
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