Immediate and long-term results of percutaneous coronary intervention for unprotected left main coronary artery stenoses
- VernacularTitle:无保护左主干病变经皮冠状动脉介入治疗的近期和远期疗效
- Author:
Fangbin HU
;
Tamai HIDEO
;
Kosuga KUNIHIKO
- Publication Type:Journal Article
- Keywords:
Coronary disease;
Percutaneous coronary intervetion;
Restenosis
- From:
Chinese Journal of Interventional Cardiology
2003;0(05):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the immediate and late outcomes after percutaneous coronary intervetion (PCI) for unprotected left main coronary artery (LMCA) stenoses. Methods Between December 1992 and December 2002, directional coronary atherectomy (DCA) and/or stenting were performed for unprotected LMCA stenoses in 174 patients (121 DCA, 53 stenting procedures), including 85 patients clarified as coronary artery bypass grafting (CABG) ineligible or at high surgical risk. Clinical follow-up examinations were conducted on an outpatient basis at least once a month in the first 6-month after the procedure, and by regular visits or phone contact later. Follow-up coronary angiography was requested 3, 6 and 12 months after initial PCI. Results Procedural success was achieved in 158 patients (90.8%). In the 6-month follow-up, all-cause mortality was 9.8% (17/174); Cardiac mortality was 4.6% (8/174) and all cardiac deaths occurred in patients at high surgical risks; Target lesion revascularization (TLR) was performed in 34 of the 152 (22.4%) patients after angiography; The estimated cardiac death-free, death-free, cardiac event-free survival were 95.4%, 89.7%, 63.8% one year after PCI; 94.3%, 85.6%, 59.8% two year after PCI; and 94.3%, 84.5%, 57.5% three year after PCI, respectively. Conclusion PCI is feasible for unprotected LMCA disease, especially for ostial and mid-shaft lesions. Despite acceptable immediate results, major adverse cardiac events after PCI remain to be an unresolved issue.
