Treatment of Ostial Right Coronary Artery Narrowings: Outcomes From the Multicenter Prospective e-ULTIMASTER Registry

e-ULTIMASTER Registry Investigators

Research output: Contribution to journalArticlepeer-review


Background: Treatment of right coronary artery (RCA) aorto-ostial (AO) lesions with bare-metal stents and first-generation drug-eluting stents (DES) was associated with worse outcomes. This study aimed to assess the effect of RCA-AO stenting with current-generation DES on the clinical outcome. Methods: The large all-comer, multicontinental e-ULTIMASTER registry included 37,198 patients of whom 4775 underwent ostial and proximal RCA percutaneous coronary intervention (PCI) using the Ultimaster stent (Terumo). The primary clinical end point was 1-year target lesion failure (TLF), a composite of cardiac death; target vessel–related myocardial infarction; or clinically indicated target lesion revascularization. Results: We compared 591 (12.4%) patients who underwent RCA-AO PCI with 4184 (87.6%) patients who underwent proximal RCA PCI. The RCA-AO group included more men and recorded significantly more comorbidities and more complex coronary anatomy. After propensity matching, the primary end point TLF occurred in 4.49% of the RCA-AO group compared with 3.00% of the proximal RCA group (P =.06). Target vessel revascularization (3.29% vs 1.90%; P =.03) and stent thrombosis (1.23% vs 0.42%, P =.01) were significantly higher among patients with RCA-AO lesions than those among patients with proximal RCA lesions. All-cause mortality was similar between the groups (2.97% vs 2.26%; P =.30). Conclusions: The treatment of RCA-AO with DES is feasible, with similar rates of TLF but with an increased risk of target vessel revascularization and stent thrombosis.

Original languageEnglish
Article number100604
JournalJournal of the Society for Cardiovascular Angiography and Interventions
Issue number3
StatePublished - 1 May 2023
Externally publishedYes

Bibliographical note

Funding Information:
The e-ULTIMASTER registry was funded by Terumo Europe, Middle East and Africa.

Publisher Copyright:
© 2023 The Authors


  • ostial lesion
  • percutaneous coronary intervention
  • right coronary artery


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