LM V-RESOLVE Score System Evaluated to Identify Lesions and Reduce Risk of PCI Complications

May 2, 2024—New data demonstrated that LM V-RESOLVE, a left main (LM) bifurcation–specific novel scoring system, could help rapidly discriminate lesions at risk of side branch (SB) occlusion during LM bifurcation percutaneous coronary intervention (PCI), thereby reducing risk during the procedure.

In the multivariable model, three routinely assessed angiographic variables (main vessel [MV]/SB diameter ratio, MV plaque ipsilateral to SB, baseline diameter stenosis of SB) were independent predictors for SB occlusion.

The results from the prospective trial were presented as late-breaking science at SCAI 2024, the Society for Cardiovascular Angiography & Interventions scientific sessions held May 2-4 in Long Beach, California.

The SCAI press release stated that the study analyzed 855 patients undergoing unprotected LM bifurcation PCI with provisional strategy. The patients were treated at Fuwai Hospital in Beijing, China, from January 2014 to December 2016.

A prediction model was selected by all-subsets logistic regression, and a multivariable risk score was established with incremental weights attributed to each component variable based on its estimate coefficients. SB occlusion was defined as any decrease in thrombolysis in myocardial infarction flow grade or absence of flow in SB after MV stenting.

The investigators reported that the risk score had a C-statistics of 0.830 with good calibration, indicating good diagnostic accuracy. SB occlusion occurred in 19 (2.22%) LM bifurcation lesions.

These results demonstrate that the novel LM V-RESOLVE score provides a strong model to find lesions at risk for SB occlusion for LM bifurcation PCI, noted the SCAI press release.

The study was led by Hao-Yu Wang, MD, with Fuwai Hospital and the Chinese Academy of Medical Sciences & Peking Union Medical College.

“SB occlusions present serious risks for patients, so it is imperative that we are using the best models to determine the risk and inform treatment strategies,” commented Dr. Wang in the SCAI press release. “The use of the novel LM V-RESOLVE score may facilitate decision-making for precise LM stenting strategy, benefitting patients and instilling greater confidence for physicians.”