Comparative evaluation of the left main coronary bifurcation stenting using different generations of DES

Methods and Results: 142 patients were included. The patients were randomized into 2 groups. Group I (n = 68), who received biodegradable drug-eluting stents (Nobori), and Group II (n=74) stenting was performed using Xience V. Inclusion criteria: hemodynamically significant stenosis of the left main coronary artery, confirmed by FFR (<0,8); stable angina classes II-IV (CCS). Primary endpoints: MACE (death, MI, TVR, TLR). Secondary endpoints: restenosis and late stent thrombosis.
The frequency of MACE in both groups was 1.7 and 0%, respectively (p = 0.08). The frequency of restenosis in the body of the left main coronary artery and the left anterior descending artery was 0%. Restenosis in the circumflex artery met at 6.9 and 4.41% of cases (p = 0.076). In this case revascularization (TLR) was needed in 6.9% of the patients in Group I and in 4.41% of the patients in Group II (p > 0,05). Stent thrombosis was diagnosed in Group I, due to the mistake of receiving dual antiplatelet therapy. Stent malposition in the circumflex artery was 1.1 % according to the data of intraoperative IVUS and OCT in both groups. The average area of the lumen of the left main coronary artery was 8,21 ± 0,05 mm2 in patients of group I and 8,52 ± 0,15 mm2 in patients of group II (p = 0.067). The average area of the lumen of the left anterior descending artery was 6.1 ± 0.54 mm2 and 7.16 ± 0,3 mm2 respectively (p = 0.07). And in the circumflex artery using methods of double bifurcation stenting this indicator was 5.78 ± 0.34 and 6,5 ± 0,61 mm2 respectively ( p = 0.066).
Conclusion: Xience stents are not inferior to Nobori in PCI in lesions of the left main coronary artery.