Bail-out stenting for left main coronary artery dissection during catheter-based procedure: acute and long-term results.
- Author:
Se Whan LEE
1
;
Seung Whan LEE
;
Myeong Ki HONG
;
Young Hak KIM
;
Cheol Whan LEE
;
Ki Hoon HAN
;
Jong Min SONG
;
Duk Hyun KANG
;
Jae Kwan SONG
;
Jae Joong KIM
;
Seong Wook PARK
;
Seung Jung PARK
Author Information
1. Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. sjpark@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Left main coronary artery;
Dissection;
Stent
- MeSH:
Angiography;
Catheters;
Constriction, Pathologic;
Coronary Vessels*;
Follow-Up Studies;
Hospital Mortality;
Humans;
Hypotension;
Myocardial Infarction;
Retrospective Studies;
Stents*
- From:Korean Journal of Medicine
2004;66(6):571-575
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The optimal treatment of patients with left main coronary artery (LMCA) dissection during catheter-based procedure remains uncertain. We retrospectively analyzed the acute and long-term results of bail-out stenting for LMCA dissection. METHODS: In cases with significant LMCA dissection occurring during catheter-based procedure, prompt stent implantation may be safe and associated with favorable clinical outcome. We evaluated the acute and long-term results of bail-out stenting for LMCA dissection occurring during catheter-based procedure in 10 patients. RESULTS: Initially, there was no significant stenosis of LMCA segment in these patients. Catheter-induced dissection occurred in 8 patients (during diagnostic angiography in 3 patients and guiding catheter manipulation in 5 patients). Two patients suffered dissection in the setting of stent deployment in other vessels. Therefore, bail-out stenting for LMCA dissection was performed in a total of 10 patients. In 4 patients, hypotension developed and intra-aortic balloon pump was placed during procedure. Stents were successfully deployed in all patients. There was no in-hospital mortality. Six-month angiographic follow-up was performed in 8 patients. Angiographic restenosis (diameter stenosis 50%) was not observed in all patients at follow-up study. During a mean follow-up of 31 +/- 25 months after hospital discharge, there was no major adverse cardiac event (death, myocardial infarction, and target lesion revascularization). CONCLUSION: Bail-out LMCA stenting is technically feasible, and showed good acute and long-term results in a small series of patients.
