Today in Medicine: Study Shows Favorable Long-Term Outcomes for DES Implantation in Unprotected Left-main Lesions

June 27, 2007 By Shaun Takao [mailto:stakao@perfuse.org]

Milan, Italy: A retrospective multicenter registry study has demonstrated favorable long-term outcomes after the implantation of drug-eluting stents (DES) in non-bifurcation lesions involving unprotected left main coronary arteries ref1.

The study, which was published this week in the online edition of Circulation, examined registry data among 147 patients who were electively treated with percutaneous coronary intervention (PCI) with DES in unprotected left main coronary artery lesions.

At a median follow-up of 886 days, the major adverse cardiac event rate was 7.4% with a cumulative cardiac mortality of 2.7%. Only seven patients required target vessel revascularization. The restenosis rate at six-month angiographic follow-up was 0.9% with a late loss of -0.01 mm. Additionally, there were no angiographically proven cases of stent thrombosis, although stent thrombosis could not be excluded in the four patients who died of unknown causes.

While the results of the study suggest that the use of drug-eluting stents in nonbifurcation unprotected left main coronary artery stenosis is both safe and effective, Dr. Alaide Chieffo and colleagues note that the results are from a retrospective registry with a relatively small number of patients due to the low occurrence of this anatomical subset. Currently there is no randomized data comparing PCI with DES implantation versus coronary artery bypass graft surgery. The ongoing SYNTAX trial will evaluate 710 patients with left main disease who have been randomized to either a DES or CABG.


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Read more about this topic in the Living Textbook of Interventional Cardiology