{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T11:07:46Z","timestamp":1785150466032,"version":"3.55.0"},"reference-count":34,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2024,10,27]],"date-time":"2024-10-27T00:00:00Z","timestamp":1729987200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Provisional single stenting strategy (PSS) is a default strategy for percutaneous coronary intervention (PCI) of unprotected left main distal bifurcation lesions (ULMD). Previous study reported that a bifurcation angle change (BAC) between end diastole and systole was associated with outcomes after PCI with double stent strategy (DSS) for ULMD. However, there are no data comparing outcomes after PCI with PSS versus DSS according the degree of BAC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We evaluated outcomes after PCI with PSS versus DSS for true ULMD with small and large BAC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We identified 566 patients with true ULMD underwent PCI in three high\u2010volume centers. We calculated the BAC in ULMD between end\u2010diastole and systole before stenting with 2\u2010dimensional quantitative coronary angiographic assessment. We defined small (BAC\u2009&lt;\u20097.0\u00b0) and large BAC (\u22657.0\u00b0) group. We compared clinical outcomes after PCI with PSS versus DSS in each cohort after propensity score adjustment. The primary endpoint was target\u2010lesion failure (TLF), which was defined as a composite of cardiac death, target lesion revascularization, and myocardial infarction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In small BAC cohort, TLF rate was significantly lower in DSS group than in PSS group (12.5% vs. 20.1%, adjusted HR 0.45; 95% CI, 0.26\u20130.79; <jats:italic>p<\/jats:italic>\u2009=\u20090.006). In contrast, in large BAC cohort, TLF rate was significantly higher in DSS group than in PSS group (54.9% vs. 29.0%, adjusted HR 2.25; 95% CI, 1.50\u20133.38; <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The TLF rate after PCI with DSS was significantly lower in true ULMD with small BAC compared to PSS even after propensity score adjustment. In contrast, it was significantly higher in those with large BAC.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.31240","type":"journal-article","created":{"date-parts":[[2024,10,28]],"date-time":"2024-10-28T06:33:22Z","timestamp":1730097202000},"page":"1362-1372","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The feasibility of double stent strategy in left main true bifurcation with small and large angle change between diastole and systole: The Milan and New\u2010Tokyo (MITO) registry"],"prefix":"10.1002","volume":"104","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4050-0275","authenticated-orcid":false,"given":"Yusuke","family":"Watanabe","sequence":"first","affiliation":[{"name":"Interventional Cardiology Unit New Tokyo Hospital Matsudo Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toru","family":"Naganuma","sequence":"additional","affiliation":[{"name":"Interventional Cardiology Unit New Tokyo Hospital Matsudo Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaide","family":"Chieffo","sequence":"additional","affiliation":[{"name":"San Raffaele Scientific Institute Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Montorfano","sequence":"additional","affiliation":[{"name":"San Raffaele Scientific Institute Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaaki","family":"Okutsu","sequence":"additional","affiliation":[{"name":"Interventional Cardiology Unit New Tokyo Hospital Matsudo Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoko","family":"Tahara","sequence":"additional","affiliation":[{"name":"Interventional Cardiology Unit New Tokyo Hospital Matsudo Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Hozawa","sequence":"additional","affiliation":[{"name":"Interventional Cardiology Unit New Tokyo Hospital Matsudo Chiba Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0651-0090","authenticated-orcid":false,"given":"Sunao","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Cardiology Kawasaki Saiwai Hospital Kawasaki Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Colombo","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences Humanitas University Milan Italy"},{"name":"Humanitas Clinical and Research Center IRCCS Rozzano\u2010Milan Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,10,27]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacasi.2022.05.003"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa035071"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacasi.2021.12.011"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2016.06.056"},{"issue":"148","key":"e_1_2_9_6_1","first-page":"e9","article-title":"AHA\/ACC\/ACCP\/ASPC\/NLA\/PCNA guideline for the management of patients with chronic coronary disease: a report of the American Heart Association\/American College of Cardiology Joint Committee on Clinical Practice Guidelines","volume":"2023","author":"Virani SS","year":"2023","journal-title":"Circulation"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz425"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.carrev.2022.07.017"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.4244\/EIJ-D-19-00144"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCINTERVENTIONS.115.003643"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.664920"},{"key":"e_1_2_9_12_1","doi-asserted-by":"crossref","DOI":"10.15420\/icr.2020.30","article-title":"Contemporary management of isolated ostial side branch disease: an evidence\u2010based approach to Medina 001 bifurcations","volume":"16","author":"Suleiman S","year":"2021","journal-title":"Interv Cardiol Rev"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.06.015"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab283"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehy394"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.29431"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0300-8932(09)71324-7"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1157\/13084649"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10157-006-0453-4"},{"key":"e_1_2_9_20_1","doi-asserted-by":"crossref","unstructured":"Erratum. 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