TCTAP A-044 Mid-term Angiographic Performance of a Self-expanding Sirolimus-eluting Stent for Left Main Percutaneous Coronary Intervention: A Substudy of the MATISSE Registry

BACKGROUND Recent data gave a percutaneous treatment of left main (LM) coronary artery disease a stronger scientific evidence. This lesion setting shares several anatomical characteristics (plaque distribution, tapered vessel, resistance to dilatation) that make a self-expandable stent theoretically favorable, in order to reduce the risk of stent malapposition and under expansion. The MATISSE study analyzed the immediate technical performance and the mid-term efficacy of the selfexpanding sirolimus-eluting Stentys stent (STENTYS S.A., France) for LM PCI in a real world, high-risk population. We here report the results of the angiographic sub-analysis of the MATISSE study. METHODS The MATISSE is an international spontaneous, multicenter registry whose results are reported elsewhere. We analyzed a subgroup of 17 patients with complete angiographic follow-up and centralized quantitative coronary angiographic analysis (QCA). Primary study end-point was late lumenloss (LLL). The secondary endpoint was binary restenosis. RESULTS Lesions were located at distal LM bifurcation site in all patients, and 15 patients received a LM-left anterior descending artery (LAD) stent. Reference vessel diameter (RVD) was 4.1 0.5 mm and percent diameter stenosis 67 28%. After device deployment and post dilatation final stenosis was 2.3 5%. Procedural success was achieved in all patients. Angiographic follow up was scheduled for all patients at an average time of 7.1 2.8 months. MLD increased at follow-up, and we observed a negative LLL of -0.03 0.6 mm in LM, and 0.07 0.51 mm in the LAD, with a percent diameter stenosis of 7.6 11% and 8.9 11%, respectively. No cases of binary restenosis were observed. CONCLUSION The use of a self-expandable stent in the distal LM setting showed good angiographic performance at mid-term followup, in a real world, high-risk population.