Comparison between provisional and dual systematic stenting approach for left main bifurcation disease: A systematic review and meta-analysis.

I Gde Rurus Suryawan Pandit Bagus Tri Saputra Made Edgard Surya Erlangga Rurus Mahendra Eko Saputra Wynne Widiarti Chaq El Chaq Zamzam Multazam Firas Farisi Alkaff

Curr Probl Cardiol

Division of Nephrology, Department of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands; Division of Pharmacology and Therapy, Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia. Electronic address:

Published: August 2024

The systematic review assesses the effectiveness of single provisional versus dual-systematic stenting for left main (LM) bifurcation disease despite recent advancements in the field.
It analyzed data from 22 studies with a total of 10,776 participants and found no significant differences in all-cause mortality, cardiovascular mortality, and other major cardiovascular events between the two stenting strategies.
The review highlights that while the outcomes are comparable, further research is needed to confirm the results of new stenting techniques, especially given the variability seen in cohort studies.

Despite recent advancements, challenges persist in determining the optimal stenting strategy for LM bifurcation disease. Hence, this systematic review aims to compare single provisional and systematic dual stenting for managing LM bifurcation disease. A systematic search was performed until January 14, 2024. For the effect measure, risk ratios (RRs) was calculated. This study included 22 studies with 10776 participants. The all-cause mortality and cardiovascular mortality revealed comparable outcomes between provisional and dual-systematic stenting (RR 1.13, CI95 %: 0.87-1.47, p 0.36, I 59 %; RR 1.16, CI95 %: 0.73-1.84, p 0.63, I 80 %). In addition, MACE, MI, TLR, TVR, and in stent thrombosis also showed similar findings. Subgroup analysis revealed that cohort studies was the source of heterogeneity in all-cause mortality, stent thrombosis, and TLR. This meta-analysis suggests comparable outcomes between provisional and dual-systematic stenting in managing LM bifurcation disease. Further study is needed to validate the outcomes of novel techniques.

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http://dx.doi.org/10.1016/j.cpcardiol.2024.102633	DOI Listing

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