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Minerva Cardioangiologica 2013 June;61(3):333-40

Copyright © 2013 EDIZIONI MINERVA MEDICA

language: English

Long term clinical outcomes in DES implantation for unprotected left main disease

Conrotto F. 1, D’amico M. 1, Ebrille E. 1, Scacciatella P. 1, Pennone M. 1, Meliga E. 2, Marra S. 1

1 Division of Cardiology, San Giovanni Battista Molinette Hospital, Turin, Italy; 2 Division of Cardiology, Mauriziano Umberto I Hospital, Turin, Italy


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Aim: Generate a long term follow-up and evaluate the impact of clinical and procedural characteristics on long term events in percutaneous coronary intervention (PCI) with drug-eluting stent (DES) implantation for unprotected left main coronary artery (ULMCA) disease.
Methods: Ninety-seven consecutive patients who underwent PCI with DES, either sirolimus (SES) or paclitaxel-eluting stent (PES), for de novo lesions in ULMCA were analyzed. No patients were excluded. Mean follow-up was 3 years (range 1-6.7 years).
Results: Technical and procedural success rate were 100% and 95.9%. According to the Academic Research Consortium definitions, cardiac death occurred in 6.1% of patients, reinfarction, target vessel revascularization (TVR) and target lesion revascularization (TLR) occurred in 6.1%, 17.5% and 4.2% of patients respectively. Definite stent thrombosis (ST) incidence was 1%, whereas possible ST occurred in 4.2% of patients. Postdilation was performed in 49.5% of patients and was, among all clinical and procedural characteristics, the only factor at multivariate analysis significantly related to lower MACE (25% vs. 46.9%, P=0.024, CI: 0.202 to 0.889) and TVR (8.3% vs. 26.5%, P=0.03 CI: 0.096-0.895).
Conclusion: Long term follow-up in PCI of ULMCA disease shows favorable clinical results. Stent postdilation seems to have a protective role in DES PCI for ULMCA disease.

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