Abstract 4595: Unprotected Left Main Stenting With a Second Generation Drug-Eluting Stent. Preliminary Results of the LEMAX Pilot Study
Background: CABG is still the gold standard treatment of unprotected left main (LM) stenosis. Percutaneous coronary intervention (PCI) is being increasingly used as an alternative therapeutic option for LM stenosis. Some studies using first generation drug-eluting stents (DES) have been published. Data regarding use of second generation DES in this setting are lacking. We present the preliminary results of a French multicenter pilot study of unprotected LM stenting with Xience V everolimus eluting stent.
Methods: A feasibility and safety pilot study using the Xience V drug eluting stent was set up in 4 French centers with a large experience in the treatment of unprotected LM stenosis. Exclusion criteria were LM restenosis, acute ST elevation MI and cardiogenic shock. In case of distal LM lesion the recomanded strategy was provisional side branch stenting. QCA analysis and adjudication of events were performed by an independent committee.
Results: Between December 2007 and May 2009, 171 patients (Pts) were included (mean age 69 years, 76% men, 27% diabetes, 12% previous MI, 29% previous PTCA, 1% previous CABG, Syntax Score 23.6±10.4, logistic Euroscore 5.7±8.1 %. In 80% of Pts the lesion treated involved the distal left main, and 81% of them were treated with only one stent. When 2 stents were used for the treatment of distal LM, T stenting technique was used in 84% of cases. Immediate angiographic procedural success was 100%. Overall in-hospital MACCE was 3.6 %: 1 death (0.6 %), 2 MI (1.2 %), 1 stroke (0.6%), 2 new PTCA (1.2%), 0 CABG (0%).
Conclusion: PCI of unprotected left main using the Xience V everolimus eluting stent provided excellent immediate angiographic results and very good in-hospital outcomes. The majority of cases involving distal LM were successfully treated with one stent. One year follow-up will be presented at the meeting.