Document Detail


Unprotected left main angioplasty in nonagenarians: clinical characteristics, procedural features and outcome: a case series study.
MedLine Citation:
PMID:  20440041     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Limited information is available on clinical characteristics and outcomes in very old patients with unprotected left main coronary artery disease (ULMCA) undergoing percutaneous coronary intervention (PCI). METHODS: From January 2004 and December 2008, 248 patients with ULMCA stenosis underwent coronary revascularization with stent implantation. Among those, 6 were older than 90 years at the time of the procedure and were included in this study. RESULTS: There were 5 males and 1 female; mean age was 91.5 years (range 91-93). All the patients presented with acute coronary syndromes. All of them had multivessel disease with a distal left main stenosis in 4 patients. All were deemed inoperable, with a mean EuroSCORE of 12.66 (range 10-20) and a predicted mortality at 34% (range15.8-86.6%). 5 patients received bare-metal stents and 1 patient a paclitaxel-eluting stent. Rotational atherectomy was required in 2 patients. Provisional side branch T-stenting with final kissing balloons was the technique used in all bifurcation lesions. Angiographic success was obtained in all patients. There were no in-hospital deaths or complications. After a 29.8-month (range 8-59) mean follow up period, a myocardial infarction caused by late stent thrombosis occurred in 1 patient and ischemia-driven target vessel revisualization was required in another; however, all patients were alive. CONCLUSION: In the very elderly patients at excessively high risk for surgery, PCI for ULMCA disease is a suitable alternative with excellent short-term results and acceptable long-term outcomes.
Authors:
Sofiene Rekik; Jérôme Brunet; Gilles Bayet; François Xavier Hager; Laurent Meille; Jean Michel Quatre; Joël Sainsous
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  22     ISSN:  1557-2501     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-04     Completed Date:  2010-08-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  231-4     Citation Subset:  IM    
Affiliation:
Cardiovascular Department, Clinique Rhône Durance, 1750, chemin du Lavarin, 84082 Avignon, France. sofienerek@yahoo.fr
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MeSH Terms
Descriptor/Qualifier:
Aged, 80 and over* / statistics & numerical data
Angioplasty, Transluminal, Percutaneous Coronary* / statistics & numerical data
Coronary Angiography
Coronary Artery Disease / epidemiology,  radiography,  therapy*
Coronary Restenosis / epidemiology
Drug-Eluting Stents
Female
Humans
Male
Metals
Risk Factors
Stents*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Metals

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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