Abstract 3053: Predictors of Restenosis After Treatment of Unprotected Left Main Trunk With Paclitaxel
Introduction. Treatment of unprotected left main trunk (LMT) has been evolving as an alternative to surgery in recent trials. However, even in the era of DES, restenosis may occur and could be a life threatening problem at follow-up.
Methods. Our objective was to evaluate the predictors of restenosis in patients who received a paclitaxel eluting stent (PES) for treatment of LMT lesions. We conducted a retrospective analysis of the patients included in the French TAXUS left main registry in whom a coronary angiogram was performed within 8 months after the procedure. In the presence of distal left main disease, a strategy of provisional side branch T stenting was applied followed by kissing balloon inflation. We assessed several categorical variables with Chi-square and continuous variable with T student as predictors of restenosis. A binary logistic regression was used to evaluate confounding factors.
Results. A group of 157 patients was evaluated. They were 66.3 ±11.1 years old, 23.2% older than 75, 28.0% diabetics and 16.3% had 3-vessel disease and Euroscore was 4.1 ± 2.7 . LMT lesion was located at the distal LMT in 117 Pts (75.0 %). In distal LMT, a second stent was deployed in the side branch in 42.5% (48 patients) and final kissing balloon inflation performed in 97.8%. Fifteen patients (9.6%) had restenosis at follow-up. The most significant variables by univariate analysis were as follows: In the multivariate analysis only diabetes remained as a significant (p <0,05) predictor of restenosis with a relative risk of 3,1.
Conclusion. In this real world study with Paclitaxel eluting stent for the treatment of LMT, the rate of restenosis in the 157 Pts who had coronary angiogram at follow-up was 9.6 %. The only predictor of restenosis by multivariate analysis was diabetes mellitus.