Kim U, Park JS, Seol SH, Yang TH, Kim SM, Kim DK, Kim DI, Kim DS, Lee WJ, Lee SH, Hong GR, Shin DG, Kim YJ, Shim BS, Cho YK, Kim HS, Nam CW, Hur SH, Kim KB, Kim YN
Two-Year Outcomes of the Sirolimus-Eluting Stent According to Unprotected Left Main Lesion. [JOURNAL ARTICLE]
Clin Cardiol 2009 Jun 30; 32(6):332-336.
BACKGROUND: The data of long-term outcomes of sirolimus-eluting stent (SES) according to lesion location of unprotected left main coronary artery (LMCA) is scarce.
HYPOTHESIS: The purpose of this study was to evaluate the long-term outcomes after implantation of the SES in LMCA.
METHODS: A total of 84 patients (51 males) who had undergone SES implantation for the treatment of native LMCA stenosis were enrolled. The patients were divided into 2 groups based on angiographic lesion location: those with significant stenosis in the ostium and/or body (group 1; n = 39) and those involving bifurcation (group 2; n = 45).
RESULTS: All of the group 1 patients were treated with simple lesion coverage while different stenting techniques were used in group 2 (cross-over: 44.8%, T: 6.7%, kissing: 37.8%, and crush techniques: 11.1%). The 8-month quantitative angiographic findings and in-hospital and 2 year rates of major adverse cardiac events (MACE) were compared between the 2 groups. Although angiographic success and in-hospital MACE rates were similar in both groups with 1 cardiac death due to acute stent thrombosis in group 2, at 2-year follow-up, the MACE rate was significantly higher in group 2 than in group 1 at 2 years (22.2% vs 2.6%, respectively, P = 0.008). Coronary angiography revealed a significantly higher binary restenosis rate in group 2 compared with group 1 (20% vs 0%, respectively, P = 0.003).
CONCLUSIONS: Interventional treatment using SES in left main lesions showed favorable short-term and long-term outcomes in selected patients with lesion location being an important determinant of clinical and angiographic outcomes. Copyright (c) 2009 Wiley Periodicals, Inc.
More from this journal |
