{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,11]],"date-time":"2026-07-11T04:18:12Z","timestamp":1783743492879,"version":"3.55.0"},"reference-count":27,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2016,11]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>There are only little data available on the comparison of clinical outcomes between a 1-stent strategy (1-SS) and a 2-stent strategy (2-SS) for percutaneous coronary intervention in unprotected distal left main disease.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              Between April 2005 and August 2011, we recruited 937 consecutive unprotected distal left main patients treated with drug-eluting stents (1-SS, 608 patients; 2-SS, 329 patients). Major adverse cardiovascular events were defined as all-cause death, myocardial infarction, or target lesion revascularization (TLR) during the median follow-up period of 1592 days. Furthermore, the individual components of major adverse cardiovascular events, cardiac death, and stent thrombosis were evaluated. More complex lesions were seen with 2-SS than with 1-SS. Cardiac death occurred more frequently with 1-SS than with 2-SS (propensity score\u2013adjusted hazard ratio, 0.52; 95% confidence interval, 0.29\u20130.64;\n              <jats:italic>P<\/jats:italic>\n              =0.03), whereas TLR occurred more frequently with 2-SS than with 1-SS (propensity score\u2013adjusted hazard ratio, 1.59; 95% confidence interval, 1.15\u20132.20;\n              <jats:italic>P<\/jats:italic>\n              =0.005). TLR was mainly driven by revascularizations after restenosis at the ostial left circumflex artery (propensity score\u2013adjusted hazard ratio, 1.94; 95% confidence interval, 1.33\u20132.82;\n              <jats:italic>P<\/jats:italic>\n              =0.001). However, there were no differences in major adverse cardiovascular events, all-cause death, stent thrombosis, and myocardial infarction. Of the 139 pairs that were propensity score matched, only TLRs were significantly higher in the 2-SS group (hazard ratio, 1.59; 95% confidence interval, 1.00\u20132.53;\n              <jats:italic>P<\/jats:italic>\n              =0.05).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>The difference between 1-SS and 2-SS in percutaneous coronary intervention for unprotected distal left main disease may be summarized by the high incidence of TLR, mainly because of restenosis at the ostial left circumflex artery in the 2-SS group.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circinterventions.116.003359","type":"journal-article","created":{"date-parts":[[2016,11,4]],"date-time":"2016-11-04T02:40:13Z","timestamp":1478227213000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":23,"title":["Comparison Between 1- and 2-Stent Strategies in Unprotected Distal Left Main Disease"],"prefix":"10.1161","volume":"9","author":[{"given":"Kensuke","family":"Takagi","sequence":"first","affiliation":[{"name":"From the Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan (K.T., T.N., Y.F., S.T., H.I., H.K., N.K., K.H., Shotaro Nakamura, Sunao Nakamura); Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (A. Chieffo, A.L., M.M., M.C., A. Colombo); and Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (A.L., A. Colombo)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toru","family":"Naganuma","sequence":"additional","affiliation":[{"name":"From the Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan (K.T., T.N., Y.F., S.T., H.I., H.K., N.K., K.H., Shotaro Nakamura, Sunao Nakamura); Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (A. Chieffo, A.L., M.M., M.C., A. Colombo); and Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (A.L., A. Colombo)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alaide","family":"Chieffo","sequence":"additional","affiliation":[{"name":"From the Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan (K.T., T.N., Y.F., S.T., H.I., H.K., N.K., K.H., Shotaro Nakamura, Sunao Nakamura); Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (A. Chieffo, A.L., M.M., M.C., A. Colombo); and Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (A.L., A. Colombo)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yusuke","family":"Fujino","sequence":"additional","affiliation":[{"name":"From the Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan (K.T., T.N., Y.F., S.T., H.I., H.K., N.K., K.H., Shotaro Nakamura, Sunao Nakamura); Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (A. Chieffo, A.L., M.M., M.C., A. Colombo); and Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (A.L., A. Colombo)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Azeem","family":"Latib","sequence":"additional","affiliation":[{"name":"From the Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan (K.T., T.N., Y.F., S.T., H.I., H.K., N.K., K.H., Shotaro Nakamura, Sunao Nakamura); Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (A. Chieffo, A.L., M.M., M.C., A. Colombo); and Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (A.L., A. Colombo)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoko","family":"Tahara","sequence":"additional","affiliation":[{"name":"From the Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan (K.T., T.N., Y.F., S.T., H.I., H.K., N.K., K.H., Shotaro Nakamura, Sunao Nakamura); Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (A. Chieffo, A.L., M.M., M.C., A. Colombo); and Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (A.L., A. Colombo)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisaaki","family":"Ishiguro","sequence":"additional","affiliation":[{"name":"From the Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan (K.T., T.N., Y.F., S.T., H.I., H.K., N.K., K.H., Shotaro Nakamura, Sunao Nakamura); Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (A. Chieffo, A.L., M.M., M.C., A. Colombo); and Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (A.L., A. Colombo)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Montorfano","sequence":"additional","affiliation":[{"name":"From the Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan (K.T., T.N., Y.F., S.T., H.I., H.K., N.K., K.H., Shotaro Nakamura, Sunao Nakamura); Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (A. Chieffo, A.L., M.M., M.C., A. Colombo); and Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (A.L., A. Colombo)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mauro","family":"Carlino","sequence":"additional","affiliation":[{"name":"From the Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan (K.T., T.N., Y.F., S.T., H.I., H.K., N.K., K.H., Shotaro Nakamura, Sunao Nakamura); Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (A. Chieffo, A.L., M.M., M.C., A. Colombo); and Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (A.L., A. Colombo)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyoshi","family":"Kawamoto","sequence":"additional","affiliation":[{"name":"From the Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan (K.T., T.N., Y.F., S.T., H.I., H.K., N.K., K.H., Shotaro Nakamura, Sunao Nakamura); Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (A. Chieffo, A.L., M.M., M.C., A. Colombo); and Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (A.L., A. Colombo)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoyuki","family":"Kurita","sequence":"additional","affiliation":[{"name":"From the Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan (K.T., T.N., Y.F., S.T., H.I., H.K., N.K., K.H., Shotaro Nakamura, Sunao Nakamura); Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (A. Chieffo, A.L., M.M., M.C., A. Colombo); and Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (A.L., A. Colombo)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koji","family":"Hozawa","sequence":"additional","affiliation":[{"name":"From the Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan (K.T., T.N., Y.F., S.T., H.I., H.K., N.K., K.H., Shotaro Nakamura, Sunao Nakamura); Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (A. Chieffo, A.L., M.M., M.C., A. Colombo); and Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (A.L., A. Colombo)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shotaro","family":"Nakamura","sequence":"additional","affiliation":[{"name":"From the Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan (K.T., T.N., Y.F., S.T., H.I., H.K., N.K., K.H., Shotaro Nakamura, Sunao Nakamura); Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (A. Chieffo, A.L., M.M., M.C., A. Colombo); and Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (A.L., A. Colombo)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunao","family":"Nakamura","sequence":"additional","affiliation":[{"name":"From the Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan (K.T., T.N., Y.F., S.T., H.I., H.K., N.K., K.H., Shotaro Nakamura, Sunao Nakamura); Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (A. Chieffo, A.L., M.M., M.C., A. Colombo); and Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (A.L., A. Colombo)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Colombo","sequence":"additional","affiliation":[{"name":"From the Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan (K.T., T.N., Y.F., S.T., H.I., H.K., N.K., K.H., Shotaro Nakamura, Sunao Nakamura); Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (A. Chieffo, A.L., M.M., M.C., A. Colombo); and Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (A.L., A. 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