Authors: Martino Pepe Massimo Napodano Giuseppe Tarantini Chiara Fraccaro Ada Cutolo Diletta Peluso Giambattista Isabella Angelo Ramondo Sabino Iliceto
Publish Date: 2010/10/21
Volume: 26, Issue: 1, Pages: 17-24
Abstract
Percutaneous treatment of unprotected left main coronary artery ULMCA stenosis using drugeluting stents DES has been suggested as the best approach for patients who are poor surgical candidates Some concerns have recently been raised regarding the risk of stent thrombosis following DES implantation This study was performed in order to evaluate the safety of DES as compared to bare metal stents BMS for ULMCA stenosis treatment in very high risk patients with a high likelihood of stent thrombosis Fortytwo consecutive patients were treated with either BMS 20 or DES 22 for ULMCA critical stenosis Inclusion criteria were ST elevation myocardial infarction nonST elevation myocardial infarction cardiogenic shock or logistic European System for Cardiac Operative Risk Evaluation ≥13 At 1 year one case of late thrombosis and three cases of restenosis were reported in the BMS group and none in the DES group leading to a significantly inferior rate of target lesion revascularization 200 vs 0 p = 0048 and major adverse cardiac events 650 vs 19 p = 0004 DES placement for ULMCA stenosis also appears to be a safe therapeutic choice in very highrisk patients as it provides the benefit of a reduction in restenosis without increasing the risk of early or late stent thrombosis
Keywords: