Cardiology B Department, CHU Rangueil, Toulouse, France.
EuroIntervention. 2011 Oct 30;7(6):680-8. doi: 10.4244/EIJV7I6A110.
To evaluate the angiographic and clinical outcome of patients undergoing paclitaxel-eluting stent (PES) implantation for unprotected left main coronary artery (ULMCA) stenosis in a "real-world" multicentre, prospective registry. Percutaneous coronary intervention (PCI) is an increasingly utilised method of revascularisation in patients with ULMCA.
A prospective registry including all patients with a significant (>50%) ULMCA stenosis. Of 151 such patients, the target lesion involved the distal bifurcation in 100 patients (66%), which was treated predominantly by a "provisional T-stenting" strategy. In the distal ULMCA disease group, 72% had only one stent implantation while 28% had multiple (either two or three) stents implanted. At a median follow-up of 1,123±80 days, cardiac death occurred in five patients (3.3%) and major adverse cardiac and cerebrovascular events (MACCE) in 32 patients (21.2%). The three-year survival rate was 93.3%.
In the drug-eluting stent era, paclitaxel-eluting stent implantation of ULMCA stenosis provided excellent immediate and long-term results in this selected population, suggesting that this approach may be considered as a safe and effective alternative to CABG for selected patients with ULMCA who are treated in experienced institutions performing large numbers of PCI procedures.
在一个“真实世界”的多中心前瞻性注册研究中，评估紫杉醇洗脱支架（PES）治疗无保护左主干冠状动脉（ULMCA）狭窄患者的血管造影和临床结果。经皮冠状动脉介入治疗（PCI）是治疗 ULMCA 患者的一种越来越常用的血运重建方法。
该前瞻性注册研究包括所有有明显（>50%）ULMCA 狭窄的患者。在 151 例此类患者中，有 100 例（66%）靶病变位于远端分叉处，主要采用“临时 T 支架”策略进行治疗。在远端 ULMCA 疾病组中，72%的患者仅植入一个支架，28%的患者植入多个（两个或三个）支架。在中位随访 1123±80 天期间，5 例患者（3.3%）发生心脏性死亡，32 例（21.2%）发生主要不良心脏和脑血管事件（MACCE）。三年生存率为 93.3%。
在药物洗脱支架时代，紫杉醇洗脱支架治疗 ULMCA 狭窄在这一选定人群中提供了极好的即刻和长期结果，表明对于在经验丰富的机构接受大量 PCI 治疗的 ULMCA 患者，这种方法可能被认为是一种安全有效的替代 CABG 的方法。
