Abstract
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 © 2009 Wiley Periodicals, Inc.
Full Text
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