Long-Term Observational Study of The Isolated Osteal Diagonal Stenosis in Patients with Chronic Coronary Syndrome

OBJECTIVE
Isolated ostial diagonal stenoses are very rare lesions in which percutaneous intervention could cause significant vessel compromise, and the long-term results have been reported in a few studies. This study sought the characteristics and long-term follow-up of the patients with isolated osteal diagonal stenosis regarding PCI and presence of angina.


METHODS
The study was an observational retrospective study conducted between January 2014 and December 2020. A total of 9769 patients who underwent coronary angiography were analyzed, and eighty-seven patients had isolated diagonal stenosis. The patients were evaluated according to treatment modality and angina severity in long-term pattern.


RESULTS
Median follow-up time was thirty-six months. A total of fifty-four (83.1%) patients were followed up with only medical treatment, and eleven (16.9%) patients underwent revascularization in addition to medical treatment. The degree of stenosis of the diagonal artery was significantly higher in the PCI group than medical group (p=0.002) and the patients with wider reference diameter of diagonal artery were complaint of more angina (p=0.007). Class I angina was significantly higher in PCI group than medical and the patients with no angina were significantly higher in medical group than PCI group.


CONCLUSIONS
PCI was mainly performed to diagonal arteries with a higher degree of stenosis; however, the patients who underwent PCI had angina more than fifty percent rates. Furthermore, the patients with ongoing angina had a larger diameter of the diagonal artery regardless of the type of treatment.