Document Detail

Unprotected left main stenting, short- and long-term outcomes.
MedLine Citation:
PMID:  21039084     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Coronary bypass surgery is recommended for the treatment of left main coronary stenosis. Recently a percutaneous approach has been described as a feasible option.
OBJECTIVES: To present the in-hospital and long-term clinical and angiographic outcome of a consecutive group of patients undergoing stenting for unprotected left main coronary artery (LMCA) disease, and to compare the clinical and angiographic outcomes of drug-eluting stent (DES) versus metal stent (BMS).
METHODS: 238 consecutive patients underwent unprotected LMCA stenting. 165 received BMS and 73 received DES. Most patients (88.7%) presented with acute coronary syndrome. Clinical (100%) and angiographic (84%) follow-up was obtained.
RESULTS: Patients' presentation: STEMI (7.2%), non-STEMI (13.5%), unstable angina (67.6%), stable angina (11.7%). Procedural success rate was 100%. In-hospital mortality was 2.1%, all in patients presented with unstable hemodynamic conditions. None of the patients needed emergent CABG. In the long-term follow-up (average three years) there were 12 deaths (5%), 3 patients required CABG and 25 patients required TVR. The overall angiographic LM restenosis rate show a trend toward lower rate in the DES group than the BMS group (9.6% versus 13.8%, P = 0.08). There was no difference in one year mortality (4.1% versus 4.2%) and AMI (2.7% versus 2.8%) between DES and BMS.
CONCLUSIONS: Stenting for LM stenosis can be performed safely with acceptable in hospital and long-term outcome. Reconsideration of current guidelines should be considered. Drug-eluting stent implantation for unprotected LMCA stenosis appears safe with regard to acute and long-term complications and is more effective in preventing restenosis compared to BMS implantation.
Dahud Qarawani; Nahir Menachem; Diab Ganem; Yonathan Hasin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Acute cardiac care     Volume:  12     ISSN:  1748-295X     ISO Abbreviation:  Acute Card Care     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-11-02     Completed Date:  2010-12-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101276603     Medline TA:  Acute Card Care     Country:  England    
Other Details:
Languages:  eng     Pagination:  124-9     Citation Subset:  IM    
Technion Institute, Haifa, Israel.
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MeSH Terms
Acute Coronary Syndrome / etiology,  mortality,  physiopathology,  therapy*
Angioplasty, Balloon, Coronary / adverse effects,  contraindications
Coronary Artery Bypass / adverse effects,  contraindications
Coronary Artery Disease / complications,  physiopathology,  therapy*
Coronary Vessels / pathology,  surgery
Drug-Eluting Stents* / adverse effects,  contraindications
Follow-Up Studies
Hospital Mortality
Long-Term Care
Middle Aged
Treatment Outcome

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

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