{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T05:44:45Z","timestamp":1761975885819,"version":"build-2065373602"},"reference-count":21,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2013,9,30]],"date-time":"2013-09-30T00:00:00Z","timestamp":1380499200000},"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":[[2014,3]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Unprotected distal left main trifurcation (ULMT) lesion represents a challenge for interventional cardiologists with the potential for peri\u2010procedural complications and adverse events at follow\u2010up especially when the main branch and the side branches are concomitantly diseased.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort analysis was performed on consecutive patients with ULMT stenosis who electively underwent percutaneous coronary intervention (PCI) with drug\u2010eluting stent (DES) implantation in order to assess the technical feasibility and long\u2010term outcomes according to the disease distribution in the trifurcation branches (true vs. non\u2010true ULMT). Primary endpoint of the study was a composite of major adverse cardiovascular events (MACE) defined as cardiac\u2010death, myocardial infarction (MI), and target lesion revascularization (TLR) during follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighty\u2010four patients underwent PCI with DES for ULMT disease during the study period (40 true trifurcation and 44 non\u2010true trifurcation). Angiographic and procedural success were obtained in 94% and 92.8% of cases. At 3\u2010years follow\u2010up, the occurrence of MACE was significantly higher in patients with true ULMT than in those with non\u2010true ULMT (HR 2.801 [confidence interval; CI 1.164\u20137.896], <jats:italic>P<\/jats:italic> = 0.025) due to a higher TLR rate (HR 3.032 [CI 1.164\u20137.896], <jats:italic>P<\/jats:italic> = 0.023). No episodes of late and very late definite\/probable stent thrombosis (ST) occurred. On multivariable analysis, a true\u2010ULMT lesion was the only independent predictor of MACE (HR 2.344 [C.I. 1.006\u20135.461], <jats:italic>P<\/jats:italic> = 0.049).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>PCI with DES for ULMT stenosis is feasible with a high procedural success rate and no definite\/probable ST reported at follow\u2010up. A true trifurcation lesion is associated with enhanced risk of MACE mainly driven by TLR. \u00a9 2013 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.25174","type":"journal-article","created":{"date-parts":[[2013,8,27]],"date-time":"2013-08-27T16:58:44Z","timestamp":1377622724000},"page":"530-538","source":"Crossref","is-referenced-by-count":15,"title":["Long\u2010term clinical outcomes following drug\u2010eluting stent implantation for unprotected distal trifurcation left main disease: The Milan\u2010New Tokyo (MITO) registry"],"prefix":"10.1002","volume":"83","author":[{"given":"Alfonso","family":"Ielasi","sequence":"first","affiliation":[{"name":"Interventional Cardiology Unit San Raffaele Scientific Institute Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kensuke","family":"Takagi","sequence":"additional","affiliation":[{"name":"Interventional Cardiology Unit San Raffaele Scientific Institute Milan Italy"},{"name":"Interventional 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