Predictive Factors Of Left Anterior Descending Coronary Artery Large Branch Blockage After Stent Implantation In Main Branch Of Anterior Descending Coronary Bifurcation Disease

Purpose: After percutaneous coronary intervention of the left anterior descending artery with bifurcation disease,the occlusion of the large branch may cause serious complications during PCI,which can affect the prognosis of the patient.The purpose of this study is to analyze the incidence of large branch occlusion after stent implantation in the main branch of the left anterior descending artery and to evaluate the factors that affect large branch vessel occlusion.Methods: This study was performed at the Department of Cardiology,of the First Affiliated Hospital of China Medical University from August 2019 to August 2020.A total of 180 cases of LAD bifurcation lesions were included according to this study’s inclusion and exclusion criteria.The basic clinical data,angiography data and PCI procedure details of the patients were collected.In this case,the coronary angiography data uses quantitative coronary analysis(QCA).Large branch occlusion is defined as a decrease in the TIMI blood flow progression of branch vessels after stent implantation in the main branch.All data analysis uses SPSS22.0 version.Results: A total of 180 patients with LAD bifurcation lesions were enrolled in this study.A total of 23 patients(12.8%)had branch occlusion.Univariate analysis found that BMI value,main branch plaque distribution on the same side of the branch,main branch calcification,main branch tortuosity,true Bifurcation lesions,proximal main branch diameter stenosis,branch diameter stenosis,branch lesion length,bifurcation angle,MV/SB diameter ratio,had significant statistical differences between the two groups,which were included in multiple factors Logistic regression model analysis,the results showed:Main branch disease tortuosity(OR: 15.7 95%CI 3.52-70.05,P<0.01),branch diameter stenosis(OR: 1.91 95%CI 1.85-1.98,P=0.01),branch disease length(OR: 1.86 95%CI1.76-1.98,P=0.02),bifurcation angle(OR: 1.93 95%CI 1.87-2.00,P=0.04),MV/SB diameter ratio(OR: 2.76 95%CI 2.04-3.25,P<0.01)can be used as an independent predictor for side branch blockage.Conclusion: This study reported that the occlusion probability of large branch vessels after the main branch of LAD bifurcation lesions is stent implanted is 12.8%.Among multiple factors,diseased main branch tortuosity,branch diameter stenosis,branch lesion length,bifurcation angle and MV/SB diameter ratio can be main predictive factors of large branch occlusion after stent implantation.