Japanese Coronary Intervention Using Drug Eluting and Perfusion Therapy for Left Main Disease (JDEPTH-LM Registry)

JDEPTH-LM Registry is a prospective observational multi-center study. The investigators will enroll and treat patients in the registry who meet the selection criteria under usual care and for whom PCI with W-KBT following on crossover stenting for LMT-LAD direction, proximal optimization technique (POT), and conventional kissing balloon technique (C-KBT) is the optimal treatment. The operators shall obtain oral or written consent from patients who meet the criteria before performing PCI, indicating the intention to perform PCI with W-KBT, and shall keep records. The investigators will continuously register cases attempting PCI with W-KBT according to the protocol and evaluate its efficacy and safety using data from this multi-center registry.

Inclusion criteria

• Age ≥ 18 years
• Patient with stable coronary artery disease, non-ST-elevation myocardial infarction, or unstable angina
• Left main disease confirmed by coronary angiography or coronary CT angiography
• Clinical and anatomical eligibility for PCI as agreed by the local Heart Team
• Patient with consent prior to undergoing PCI
• Left main Medina classification (1,1,1), (1,0,1), (0,1,1), (0,0,1) confirmed by coronary angiography
• De novo target lesion in LMT-LAD amenable for crossover stenting with provisional side-branch approach as determined by PCI operator
• De novo ostial LCx lesions
• Lesion indicated in No. 8 with a length of less than 10 mm or a stenosis of less than 70% confirmed by coronary angiography

Exclusion criteria

• Inability to provide written informed consent
• Patient with a history of ST-elevation myocardial infarction within the previous 1 week
• Patient in a state of cardiogenic shock
• Patient with a history of coronary artery bypass grafting
• Patient with malignant tumors or other conditions with a life expectancy of less than one year
• Patient considered suitable for stent placement in the ostial LCx from a medical perspective
• Patient considered unsuitable for anti-thrombotic therapy after PCI
• Other patient whom the investigator deems unsuitable for the safe conduct of LM-PCI, including W-KBT