Background: Left main (LM) percutaneous coronary intervention (PCI) remains a major interventional challenge, with outcomes influenced by various patient- and procedure-related factors.

Objectives: To analyze procedural characteristics and outcomes of patients who underwent LM PCI over a 15-year period in a single center.

Methods: We retrospectively analyzed data from all consecutive patients who underwent LM PCI between 2006 and 2022. Procedural details, with a focus on stenting technique, were collected. Primary outcome was all-cause mortality at 1 year.

Results: In total 3494 patients were included. The majority (67%) presented with chronic coronary syndrome. Seventy-seven percent of all patients (n = 2690) underwent PCI by single stent (SS) strategy and 23% (n = 804) by double stent (DS) strategy. One-year mortality was significantly lower in SS cases compared to DS (3.5% vs. 5.1%, HR 0.64, 95% CI 0.43-0.96). Intravascular imaging was used in 17% of the cases but showed no significant difference in one-year mortality compared to angio-guided PCI (4.8% vs. 3.7%; HR 1.11, 95% CI 0.71-1.73).

Conclusions: In real-world LM PCI practice, patients for whom a provisional single-stent strategy was feasible had better outcomes than those requiring a double-stent approach.

Keywords: Left main; coronary bifurcation; double stent technique; imaging guidance; percutaneous revascularization; single stent technique.

背景: 左主干（LM）经皮冠状动脉介入治疗（PCI）仍然是一个重大的介入挑战，其结果受多种患者和操作相关因素的影响。

目的: 分析15年内单中心接受LM PCI的患者的程序特征及结局。

方法: 我们回顾性分析了2006年至2022年间所有连续接受LM PCI患者的数据。收集了关于支架技术的详细操作信息，主要结果指标是一年内全因死亡率。

结果: 共纳入3494名患者。大多数（67%）表现为慢性冠状动脉综合征。所有患者中有77%（n = 2690）采用单支架（SS）策略，而23%（n = 804）采用双支架（DS）策略。与双支架组相比，单支架组一年内死亡率显著较低（3.5% vs. 5.1%，HR 0.64，95% CI 0.43-0.96）。在17%的情况下使用了血管内成像技术，但其一年内的死亡率与单纯依靠造影引导的PCI相比并无显著差异（4.8% vs. 3.7%；HR 1.11，95% CI 0.71-1.73）。

结论: 在实际的LM PCI实践中，对于可以采取临时单支架策略的患者有更好的结局，而那些需要双支架方法的患者的结局较差。

关键词: 左主干；冠状动脉分支；双支架技术；影像引导；经皮再血管化；单支架技术。