{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T22:19:47Z","timestamp":1761862787351},"reference-count":11,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2008,10,27]],"date-time":"2008-10-27T00:00:00Z","timestamp":1225065600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2009,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p><jats:styled-content>Objectives:<\/jats:styled-content> We aimed to conduct a retrospective cohort study focusing on our 5\u2010year experience in the percutaneous treatment of unprotected left main (ULM) trifurcation disease. <jats:styled-content>Background:<\/jats:styled-content> Percutaneous treatment of ULM trifurcation remains a challenging and rare procedure for most interventional cardiologists. Moreover, data on long\u2010term outcomes are lacking. <jats:styled-content>Methods:<\/jats:styled-content> We retrieved all patients with ULM trifurcation disease treated percutaneously at our Institution since 2002, and adjudicated baseline, procedural, and outcome data. The primary end point was the long\u2010term rate of major adverse cardiovascular events (MACE, i.e., cardiac death, myocardial infarction, bypass surgery, or target vessel revascularization). <jats:styled-content>Results:<\/jats:styled-content> A total of 27 patients underwent percutaneous coronary intervention with stent implantation for ULM trifurcation disease, with 14 (52%) cases of true trifurcations, i.e., with concomitant significant stenoses of the distal ULM\/ostial left anterior descending plus ostial ramus intermedius and ostial circumflex. Bare\u2010metal stents were implanted in 8 (29%) patients and drug\u2010eluting stents (DES) in 26 (96%), with a main branch stent only strategy in 11 (40%), T stenting in 9 (33%), and V stenting in 6 (27%). Procedural and clinical success occurred in 26 (96%), with one postprocedural death. Angiographic follow\u2010up was obtained in 22 patients (81%), and clinical follow\u2010up was completed in all subjects after a median of 28 \u00b1 17 months, showing overall MACE in 9 (33%), with cardiac death in 4 (15%), myocardial infarction in 1 (4%), coronary artery bypass grafting (CABG) in 4 (15%), and percutaneous target vessel revascularization in 5 (19%). Definite stent thrombosis was adjudicated in 1 (3%) patient. Treatment of a true trifurcation lesion and recurrence of angina during follow\u2010up were significantly associated with an increased risk of MACE (<jats:italic>P<\/jats:italic> = 0.029 and <jats:italic>P<\/jats:italic> = 0.050, respectively). <jats:styled-content>Conclusions:<\/jats:styled-content> Percutaneous treatment of ULM trifurcation disease is feasible, associated with favorable mid\u2010term results, and may be considered given its low invasiveness in patients at high surgical risk or with multiple comorbidities. \u00a9 2008 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/ccd.21759","type":"journal-article","created":{"date-parts":[[2008,10,27]],"date-time":"2008-10-27T17:31:33Z","timestamp":1225128693000},"page":"25-31","source":"Crossref","is-referenced-by-count":15,"title":["Early and long\u2010term results of percutaneous coronary intervention for unprotected left main trifurcation disease"],"prefix":"10.1002","volume":"73","author":[{"given":"Imad","family":"Sheiban","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Argyrios","family":"Gerasimou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario","family":"Bollati","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Biondi\u2010Zoccai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filippo","family":"Sciuto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pierluigi","family":"Omed\u00e9","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dario","family":"Sillano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gian Paolo","family":"Trevi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudio","family":"Moretti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2008,12,16]]},"reference":[{"key":"e_1_2_5_2_2","first-page":"61","volume-title":"The Evolution of Cardiac Catheterization and Interventional Cardiology","author":"Meier B","year":"2006"},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000024983.34728.5D"},{"key":"e_1_2_5_4_2","first-page":"356","article-title":"Sirolimus\u2010eluting stents vs. bare metal stents for the treatment of unprotected left main coronary artery stenosis","volume":"2","author":"Sheiban I","year":"2006","journal-title":"EuroIntervention"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2007.03.041"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2007.10.009"},{"key":"e_1_2_5_7_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.21314"},{"key":"e_1_2_5_8_2","first-page":"32","article-title":"Trifurcating coronary artery disease: A proposed classification and treatment methodology","volume":"19","author":"Shammas NW","year":"2007","journal-title":"J Invasive Cardiol"},{"key":"e_1_2_5_9_2","first-page":"77","article-title":"Long\u2010term outcomes in treating left main trifurcation coronary artery disease with the Paclitaxel\u2010eluting stent","volume":"19","author":"Shammas NW","year":"2007","journal-title":"J Invasive Cardiol"},{"key":"e_1_2_5_10_2","doi-asserted-by":"publisher","DOI":"10.1157\/13084649"},{"key":"e_1_2_5_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(03)01050-7"},{"key":"e_1_2_5_12_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0801441"}],"container-title":["Catheterization and Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fccd.21759","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.21759","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,13]],"date-time":"2023-11-13T23:42:56Z","timestamp":1699918976000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.21759"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,12,16]]},"references-count":11,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2009,1]]}},"alternative-id":["10.1002\/ccd.21759"],"URL":"https:\/\/doi.org\/10.1002\/ccd.21759","archive":["Portico"],"relation":{},"ISSN":["1522-1946","1522-726X"],"issn-type":[{"value":"1522-1946","type":"print"},{"value":"1522-726X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,12,16]]}}}