Abstract 3658: Favourable One Year Outcome Following Drug Eluting Stent Implantation in Non Bifurcational Lesions Involving Unprotected Left Main Coronary Artery: a Multicenter Registry
Background The presence of a lumen narrowing at the ostium and the body of an unprotected left main coronary artery (LMCA), which does not require bifurcation treatment, is a class I indication to surgical revascularization. The aim of the study was to assess the safety and mid-term efficacy of drug-eluting stent (DES) implantation in the ostium and/or body of unprotected LMCA stenosis.
Methods and Results One-hundred forty four consecutive patients (pts) who had sirolimus (n= 105) or paclitaxel-eluting stents (n= 39) electively implanted for the treatment of ostial and/or body LMCA stenosis not requiring the treatment of the bifurcation were included in this multicenter registry. Seventy-five patients had ostial LMCA stenosis, 41 in the body and 28 had diffuse disease in either ostium or the body of the left main. In 73 (50.7 %) patients IVUS guidance was performed. Procedural success was achieved in 99% of the pts; in one patient with stenosis in the LMCA ostium, a residual stenosis, more than 30%, persisted at the end of the procedure and the patient was referred for coronary artery by-pass grafting (CABG). During hospitalization no patient had Q wave myocardial infarction (MI) or died. One patient died 19 days after the procedure because of pulmonary infection. At 12months no other patient died or had MI. Two patients had TVR (1 re-PCI and 1 CABG). Angiographic follow-up was performed in 100pts (70%) with a late loss of -0.09 mm. Restenosis in left main trunk occurred only in 1 (1%) patient (in-stent Taxus).
Conclusions PCI with DES implantation in non-bifurcation LMCA lesions appears safe with a favorable 2.7 % overall MACE occurrence at twelve months and an encouraging 1% restenosis rate.