Journal of The Showa Medical Association
Online ISSN : 2185-0976
Print ISSN : 0037-4342
ISSN-L : 0037-4342
INITIAL AND LONG-TERM OUTCOMES OF ELECTIVE PCI FOR UNPROTECTED LEFT MAIN CORONARY ARTERY STENOSIS
(Effectiveness of Sirolimus-eluting Stent)
Hiroshi ARAKIMasahiko OCHIAIChiaki OBARAMyong Hwa YAMAMOTOSigeo SAITOKoichi HOSHIMOTOYuki MIKOSHIBANaoei ISOMURAKazuhiro ASHIDA
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2008 Volume 68 Issue 5 Pages 272-279

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Abstract

We evaluated the initial and long-term outcomes of elective unprotected left main coronary artery (UPLMCA) stenting and compared sirolimus-eluting stent (SES) implantation with bare metal stent (BMS) . From April 2001 to March 2006, elective percutaneous coronary intervention (PCI) for de novo UPLMCA stenosis was performed in 45 consecutive patients (21 patients were treated with SES and 24 patients with BMS) . The procedural success rate was 100% in both groups. There was no in-hospital complication such as death, Q-wave myocardial infarction, emergent repeated PCI and coronary artery bypass grafting (CABG) in either group. From 6 to 12 months after the procedure. CABG rate was significantly lower in the SES group than in the BMS group (0% vs. 16.7%, p=0.05) . There was no significant difference in angiographic restenosis rate (9.5% vs. 20.8%, p=0.29) and target lesion revascularization (TLR) (4.7% vs. 20.8%, p=0.11) between the two groups. Quantitative coronary angiography showed a shorter reference vessel diameter (3.47±0.38 vs. 3.98±p=0.01), shorter post procedural minimal lumen diameter (3.53mm vs. 4.13mm, p<0.01), and longer lesion length (18.7mm vs. 14.0mm, p=0.02) in the SES group. Our PCI for UPLMCA stenosis can be performed with good initial and long-term outcomes. SES stenting resulted in a lower CABG rate and smaller and longer treatable lesions. Our results indicate that the use of UPLMCA stenosis PCI could be expanded in the SES area.

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