Contemporary Percutaneous Treatment of Unprotected Left Main Coronary Stenoses

Ellis, Stephen G.; Tamai, Hideo; Nobuyoshi, Masakiyo; Kosuga, Kunihiko; Colombo, Antonio; Holmes, David R.; Macaya, Carlos; Grines, Cindy L.; Whitlow, Patrick L.; White, Harvey; Moses, Jeffrey J.; Teirstein, Paul S.; Serruys, Patrick W.; Bittl, John A.; Mooney, M.; Shimshak, Thomas M.; Block, Peter C.; Erbel, Raimund

doi:10.1161/01.cir.96.11.3867

Cited by 192 publications

(105 citation statements)

References 11 publications

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“…With increasing operator experience, refinement in technology, and the availability of improved stent designs, percutaneous coronary intervention (PCI) is now considered the treatment of choice for many high-risk subgroups in whom it was previously contraindicated [1][2][3]. In 2002 an estimated 657,000 PCI procedures were performed on 640,000 patients in the United States.…”

Section: Introductionmentioning

confidence: 99%

Tree-structured risk stratification of in-hospital mortality after percutaneous coronary intervention for acute myocardial infarction: A report from the New York State percutaneous coronary intervention database

Negassa¹,

Monrad²,

Bang³

et al. 2007

American Heart Journal

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Section: Introductionmentioning

confidence: 99%

Tree-structured risk stratification of in-hospital mortality after percutaneous coronary intervention for acute myocardial infarction: A report from the New York State percutaneous coronary intervention database

Negassa¹,

Monrad²,

Bang³

et al. 2007

American Heart Journal

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“…1,2 Some studies have demonstrated that stenting of the ULM is feasible and appears to be a promising strategy in selected patients. [3][4][5][6][7][8] Recently, use of a drug-eluting stent (DES), either a sirolimus-eluting stent (SES; Cypher, Cordis, Johnson and Johnson Co) or a paclitaxel-eluting stent (PES; Taxus, Boston Scientific), has been associated with a low restenosis rate. 9 -13 A single-center observational study recently reported encouraging results with the treatment of left main stenosis, either protected or unprotected, with SES.…”

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Early and Mid-Term Results of Drug-Eluting Stent Implantation in Unprotected Left Main

et al. 2005

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“…9 However, advances in intervention techniques and the use of DES are providing encouraging results in the treatment of LMCA stenosis. 10 In fact, DES have emerged as the favored percutaneous treatment modality for LMCA stenosis because of significant reductions in restenosis and TLR rates 11 as shown by a number of registries and nonrandomized studies that have demonstrated the effectiveness of DES for LMCA stenosis; 3 -5,12,13 however, there has been scant data available on long-term clinical follow-up in LMCA lesions treated with DES.…”

Section: Discussionmentioning

confidence: 99%

Two‐Year Outcomes of the Sirolimus‐Eluting Stent According to Unprotected Left Main Lesion

Kim

Park

Seol

et al. 2009

Clinical Cardiology

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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 longterm outcomes in selected patients with lesion location being an important determinant of clinical and angiographic outcomes. IntroductionPercutaneous coronary intervention (PCI) with drug-eluting stent (DES) has been associated with marked reductions in restenosis rates 1 and neointimal hyperplasia formation; 2 this also appears to be the case for the treatment of unprotected left main coronary artery (LMCA) lesions, 3 -5 an observation that stands in contrast with the fact that in the bare-metal stent era an LMCA lesion was a definite indication for coronary artery bypass graft (CABG) surgery. However, there is little data on the long-term outcomes according to LMCA lesion complexity and location and therefore this registry study was aimed at evaluating long-term clinical and angiographic outcomes according to LMCA lesion location post sirolimus-eluting stent (SES) implantation.

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Contemporary Percutaneous Treatment of Unprotected Left Main Coronary Stenoses

Cited by 192 publications

References 11 publications

Tree-structured risk stratification of in-hospital mortality after percutaneous coronary intervention for acute myocardial infarction: A report from the New York State percutaneous coronary intervention database

Tree-structured risk stratification of in-hospital mortality after percutaneous coronary intervention for acute myocardial infarction: A report from the New York State percutaneous coronary intervention database

Early and Mid-Term Results of Drug-Eluting Stent Implantation in Unprotected Left Main

Two‐Year Outcomes of the Sirolimus‐Eluting Stent According to Unprotected Left Main Lesion

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