Impact of interventional strategy for unprotected left main coronary artery percutaneous coronary intervention on long-term survival

The Canadian Journal of Cardiology
Ralf LehmannStephan Fichtlscherer

Abstract

Percutaneous coronary intervention (PCI) of unprotected left main coronary artery (ULMCA) is feasible. In cases involving the left anterior descending-left circumflex bifurcation, the optimal interventional strategy remains unclear. Randomized bifurcation trials in the past excluded ULMCA lesions. A single-centre registry study with retrospective analysis of the interventional protocols and procedural angiograms of 102 patients who underwent stent PCI of ULMCA was performed in order to evaluate the impact of the interventional strategy on long-term survival. Isolated stenting of the ostium or mid ULMCA without bifurcation stenting was performed in 19 patients. Most interventions (n = 83) involved the left main bifurcation. Distal or bifurcation lesions were treated by provisional T-stenting in cases of single involved ostium (left anterior descending or right circumflex) or systematic T-stenting or V-stenting if both proximal coronary arteries were involved (n = 19). The majority (96%) of patients received drug-eluting stents. The long-term survival (mean follow-up = 3.4 ± 1.7 years) of patients was influenced by the interventional strategy. A single-stent strategy involving the bifurcation without side branch intervention was ...Continue Reading

References

May 2, 2006·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Georgios SianosPatrick W Serruys
Jun 15, 2010·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·David Hildick-SmithUNKNOWN European Bifurcation Club
Feb 26, 2011·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Issam D Moussa
Apr 27, 2011·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Won-Jang KimSeung-Jung Park

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Citations

Nov 23, 2012·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Shao-Liang ChenSong Lin
Dec 3, 2014·The Canadian Journal of Cardiology·Matthew SibbaldVladimír Džavík
Mar 10, 2015·Circulation Journal : Official Journal of the Japanese Circulation Society·Youngjin ChoHyo-Soo Kim
May 21, 2015·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Tobias SchmidtMartin W Bergmann

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