Percutaneous revascularization of unprotected left main: results of PCI using drug-eluting stent in ostial versus distal bifurcation disease.

BACKGROUND

Coronary artery bypass graft surgery is standard treatment for unprotected left main coronary artery disease. Recently, drug-eluting stents have been used to treat unprotected left main coronary artery disease.

OBJECTIVE

To analyze data for consecutive patients treated at a single center with drug-eluting stents for unprotected left main coronary artery disease.

RESULTS

Seventy-three patients underwent elective percutaneous coronary intervention of unprotected left main coronary artery disease. Twenty-one (30%) of the patients had disease involving the ostium or midshaft of the left main, while the remaining 52 (70%) patients had distal bifurcation disease. The group consisted of high-risk patients with an average European System for Cardiac Operative Risk Evaluation of 9% (range 0.9%-54%). After 1 year follow-up, 3 (4%) patients died; 8 patients (11%) had target vessel revascularization; 4 with repeat percutaneous coronary intervention; and 4 with coronary artery bypass graft surgery. All the events occurred in the distal bifurcation group.

CONCLUSION

These results from a single-center registry suggest the safety of performing percutaneous coronary intervention with drug-eluting stents in unprotected left main coronary artery disease with low major adverse cardiac events (MACE) rates at 1 year.