{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T08:40:34Z","timestamp":1775119234019,"version":"3.50.1"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2013,4]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>The presence of chronic total occlusion of the right coronary artery (CTO-RCA) in patients undergoing percutaneous interventions for unprotected left main (ULM) disease may affect the prognosis. In this study, we evaluated the immediate results and follow-up of patients with ULM-percutaneous interventions and with or without associated CTO-RCA.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              Between March 2002 and December 2008, a total of 568 consecutive patients with ULM stenosis treated with drug-eluting stent were included in this analysis. The mean EuroScore and SYNTAX scores were 4.05\u00b12.62 and 28.12\u00b110.82, respectively. Of these, 522 had ULM lesions without residual CTO-RCA (493 ULM without CTO-RCA+29 ULM with treated CTO-RCA), and 46 patients had residual CTO-RCA. At 1466 days (interquartile range, 1150\u20131917) follow-up, the cardiac-death occurred in 41 patients (7.2%). Cardiac-death was more frequently observed in patients with ULM and residual CTO-RCA as compared with those without residual CTO-RCA (adjusted hazard ratios, 2.163 [95% confidence interval, 1.018\u20134.597];\n              <jats:italic>P<\/jats:italic>\n              =0.045). However, target lesion revascularization occurred less frequently in patients with residual CTO-RCA (adjusted hazard ratios, 0.321 [95% confidence interval, 0.13\u20130.794];\n              <jats:italic>P<\/jats:italic>\n              =0.014), resulting in the similar major adverse cardiovascular events rates between the 2 groups. When we analyzed patients with concomitant ULM and CTO-RCA, cardiac-death was significantly higher in patients with residual as compared with treated CTO-RCA (log-rank\n              <jats:italic>P<\/jats:italic>\n              =0.01) despite no difference in baseline characteristics.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Cardiac-death occurred more frequently in patients with residual CTO-RCA as compared with those without residual CTO-RCA. These findings suggest that recanalization of CTO-RCA has significant impact on the long-term cardiac-mortality in patients undergoing ULM-percutaneous interventions probably by offering reserve coronary circulation, if in-stent restenosis were to occur in the treated left main.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circinterventions.112.000079","type":"journal-article","created":{"date-parts":[[2013,4,10]],"date-time":"2013-04-10T01:06:56Z","timestamp":1365556016000},"page":"154-160","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":23,"title":["Impact of Residual Chronic Total Occlusion of Right Coronary Artery on the Long-term Outcome in Patients Treated for Unprotected Left Main Disease"],"prefix":"10.1161","volume":"6","author":[{"given":"Kensuke","family":"Takagi","sequence":"first","affiliation":[{"name":"From the Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (K.T., A.C., S.B., A.L., M.M., M.C., H.M., T.H., C.G., F.F., J.S., A.R., S.F., C.B., A.C.); Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (K.T., S.B., A.L., T.H., C.G., F.F., J.S., A.R., A.C.); and Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan (K.T., T.N., Y.F., S.N.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfonso","family":"Ielasi","sequence":"additional","affiliation":[{"name":"From the Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (K.T., A.C., S.B., A.L., M.M., M.C., H.M., T.H., C.G., F.F., J.S., A.R., S.F., C.B., A.C.); Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (K.T., S.B., A.L., T.H., C.G., F.F., J.S., A.R., A.C.); and Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan (K.T., T.N., Y.F., S.N.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alaide","family":"Chieffo","sequence":"additional","affiliation":[{"name":"From the Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (K.T., A.C., S.B., A.L., M.M., M.C., H.M., T.H., C.G., F.F., J.S., A.R., S.F., C.B., A.C.); Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (K.T., S.B., A.L., T.H., C.G., F.F., J.S., A.R., A.C.); and Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan (K.T., T.N., Y.F., S.N.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandeep","family":"Basavarajaiah","sequence":"additional","affiliation":[{"name":"From the Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (K.T., A.C., S.B., A.L., M.M., M.C., H.M., T.H., C.G., F.F., J.S., A.R., S.F., C.B., A.C.); Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (K.T., S.B., A.L., T.H., C.G., F.F., J.S., A.R., A.C.); and Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan (K.T., T.N., Y.F., S.N.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Azeem","family":"Latib","sequence":"additional","affiliation":[{"name":"From the Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (K.T., A.C., S.B., A.L., M.M., M.C., H.M., T.H., C.G., F.F., J.S., A.R., S.F., C.B., A.C.); Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (K.T., S.B., A.L., T.H., C.G., F.F., J.S., A.R., A.C.); and Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan (K.T., T.N., Y.F., S.N.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matteo","family":"Montorfano","sequence":"additional","affiliation":[{"name":"From the Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (K.T., A.C., S.B., A.L., M.M., M.C., H.M., T.H., C.G., F.F., J.S., A.R., S.F., C.B., A.C.); Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (K.T., S.B., A.L., T.H., C.G., F.F., J.S., A.R., A.C.); and Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan (K.T., T.N., Y.F., S.N.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mauro","family":"Carlino","sequence":"additional","affiliation":[{"name":"From the Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (K.T., A.C., S.B., A.L., M.M., M.C., H.M., T.H., C.G., F.F., J.S., A.R., S.F., C.B., A.C.); Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (K.T., S.B., A.L., T.H., C.G., F.F., J.S., A.R., A.C.); and Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan (K.T., T.N., Y.F., S.N.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyuki","family":"Mizuno","sequence":"additional","affiliation":[{"name":"From the Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (K.T., A.C., S.B., A.L., M.M., M.C., H.M., T.H., C.G., F.F., J.S., A.R., S.F., C.B., A.C.); Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (K.T., S.B., A.L., T.H., C.G., F.F., J.S., A.R., A.C.); and Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan (K.T., T.N., Y.F., S.N.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tasuku","family":"Hasegawa","sequence":"additional","affiliation":[{"name":"From the Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (K.T., A.C., S.B., A.L., M.M., M.C., H.M., T.H., C.G., F.F., J.S., A.R., S.F., C.B., A.C.); Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (K.T., S.B., A.L., T.H., C.G., F.F., J.S., A.R., A.C.); and Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan (K.T., T.N., Y.F., S.N.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cosmo","family":"Godino","sequence":"additional","affiliation":[{"name":"From the Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (K.T., A.C., S.B., A.L., M.M., M.C., H.M., T.H., C.G., F.F., J.S., A.R., S.F., C.B., A.C.); Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (K.T., S.B., A.L., T.H., C.G., F.F., J.S., A.R., A.C.); and Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan (K.T., T.N., Y.F., S.N.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filippo","family":"Figini","sequence":"additional","affiliation":[{"name":"From the Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (K.T., A.C., S.B., A.L., M.M., M.C., H.M., T.H., C.G., F.F., J.S., A.R., S.F., C.B., A.C.); Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (K.T., S.B., A.L., T.H., C.G., F.F., J.S., A.R., A.C.); and Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan (K.T., T.N., Y.F., S.N.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joanne","family":"Shannon","sequence":"additional","affiliation":[{"name":"From the Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (K.T., A.C., S.B., A.L., M.M., M.C., H.M., T.H., C.G., F.F., J.S., A.R., S.F., C.B., A.C.); Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (K.T., S.B., A.L., T.H., C.G., F.F., J.S., A.R., A.C.); and Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan (K.T., T.N., Y.F., S.N.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ahmed","family":"Rezq","sequence":"additional","affiliation":[{"name":"From the Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (K.T., A.C., S.B., A.L., M.M., M.C., H.M., T.H., C.G., F.F., J.S., A.R., S.F., C.B., A.C.); Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (K.T., S.B., A.L., T.H., C.G., F.F., J.S., A.R., A.C.); and Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan (K.T., T.N., Y.F., S.N.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Santo","family":"Ferrarello","sequence":"additional","affiliation":[{"name":"From the Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (K.T., A.C., S.B., A.L., M.M., M.C., H.M., T.H., C.G., F.F., J.S., A.R., S.F., C.B., A.C.); Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (K.T., S.B., A.L., T.H., C.G., F.F., J.S., A.R., A.C.); and Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan (K.T., T.N., Y.F., S.N.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chiara","family":"Bernelli","sequence":"additional","affiliation":[{"name":"From the Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (K.T., A.C., S.B., A.L., M.M., M.C., H.M., T.H., C.G., F.F., J.S., A.R., S.F., C.B., A.C.); Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (K.T., S.B., A.L., T.H., C.G., F.F., J.S., A.R., A.C.); and Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan (K.T., T.N., Y.F., S.N.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toru","family":"Naganuma","sequence":"additional","affiliation":[{"name":"From the Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (K.T., A.C., S.B., A.L., M.M., M.C., H.M., T.H., C.G., F.F., J.S., A.R., S.F., C.B., A.C.); Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (K.T., S.B., A.L., T.H., C.G., F.F., J.S., A.R., A.C.); and Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan (K.T., T.N., Y.F., S.N.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yusuke","family":"Fujino","sequence":"additional","affiliation":[{"name":"From the Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (K.T., A.C., S.B., A.L., M.M., M.C., H.M., T.H., C.G., F.F., J.S., A.R., S.F., C.B., A.C.); Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (K.T., S.B., A.L., T.H., C.G., F.F., J.S., A.R., A.C.); and Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan (K.T., T.N., Y.F., S.N.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sunao","family":"Nakamura","sequence":"additional","affiliation":[{"name":"From the Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (K.T., A.C., S.B., A.L., M.M., M.C., H.M., T.H., C.G., F.F., J.S., A.R., S.F., C.B., A.C.); Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (K.T., S.B., A.L., T.H., C.G., F.F., J.S., A.R., A.C.); and Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan (K.T., T.N., Y.F., S.N.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonio","family":"Colombo","sequence":"additional","affiliation":[{"name":"From the Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (K.T., A.C., S.B., A.L., M.M., M.C., H.M., T.H., C.G., F.F., J.S., A.R., S.F., C.B., A.C.); Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (K.T., S.B., A.L., T.H., C.G., F.F., J.S., A.R., A.C.); and Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan (K.T., T.N., Y.F., S.N.)."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.10.005"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.108.800805"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.105.595694"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2004.10.039"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.899211"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.109.873349"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.108.804930"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/circinterventions.108.847137"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehr213"},{"key":"e_1_3_2_11_2","first-page":"199","article-title":"A new proposed simplified classification of coronary artery bifurcation lesions and bifurcation interventional techniques.","volume":"18","author":"Movahed MR","year":"2006","unstructured":"Movahed MR, Stinis CT. 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