<h2 class="section-title u-h3 u-margin-l-top u-margin-xs-bottom">Abstract</h2> <div id="as0005"> <h3 class="u-h4 u-margin-m-top u-margin-xs-bottom" id="st0010">Purpose</h3> <p id="sp0080">We sought to evaluate angiographic outcomes in ostial and distal LM lesions.</p> </div> <div id="as0010"> <h3 class="u-h4 u-margin-m-top u-margin-xs-bottom" id="st0015">Methods</h3> <p id="sp0085">176 patients with LM disease undergoing PCI were retrospectively included in this study. 9 months of angiographic and 12 months of clinical follow-up was obtained. Quantitative coronary analysis (QCA) was performed for all lesions, using an 11-segment model.<span> </span><a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/clinical-endpoint" title="Learn more about Clinical endpoint from ScienceDirect's AI-generated Topic Pages">Clinical endpoint</a><span><span> </span>measure was a composite endpoint of cardiac death, myocardial infarction and<span> </span><a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/target-lesion-revascularization" title="Learn more about target lesion revascularization from ScienceDirect's AI-generated Topic Pages">target lesion revascularization</a><span> </span>(TLR).</span></p> </div> <div id="as0015"> <h3 class="u-h4 u-margin-m-top u-margin-xs-bottom" id="st0020">Results</h3> <p id="sp0090">During 12 months follow up after successful PCI, the composite endpoint occurred more frequently in distal LM bifurcation lesions mainly driven by elevated TLR rates (14.1% in distal LM disease vs. 5.6% in ostial/midshaft LM disease, P = 0.20). Concordantly angiographic binary<span> </span><a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/restenosis" title="Learn more about restenosis from ScienceDirect's AI-generated Topic Pages">restenosis</a><span><span> </span>(8.2% compared to 0.0%) and late lumen loss (LLL, 0.42 ± 0.97 vs. 0.28 ± 0.34 mm) were increased in distal LM bifurcation lesions compared to ostial LM lesions. In distal lesions highest values for LLL were observed in segments adjacent to the bifurcation (0.37 ± 1.13 mm and 0.37 ± 0.73 mm). On cox proportional regression analysis the angiographic parameter LLL in a bifurcation segment (P = 0.03, HR 1.68 [1.1–2.7]) as well as presence of diabetes mellitus as a clinical parameter (P = 0.046, HR 2.77 [1.0–7.5]) were independent correlates for occurrence of<span> </span><a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/major-adverse-cardiac-event" title="Learn more about MACE from ScienceDirect's AI-generated Topic Pages">MACE</a><span> </span>in distal LM bifurcations lesions.</span></p> </div> <div id="as0020"> <h3 class="u-h4 u-margin-m-top u-margin-xs-bottom" id="st0025">Conclusion</h3> <p id="sp0095">PCI of ostial LM in accomplished with low LLL (0.28 ± 0.34 mm) and binary<span> </span><a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/restenosis" title="Learn more about restenosis from ScienceDirect's AI-generated Topic Pages">restenosis</a><span> </span>rates. In distal left main lesions highest rates for LLL and binary restenosis were observed in segments nearest to the bifurcation and rather focused on the main vessel (0.42 ± 0.97 mm).</p> </div>