Stenting of Unprotected Left Main Coronary Artery Stenoses: Immediate and six months Outcomes

Abstract

Background: Revascularization with coronary bypass grafting (CABG) has been the gold standard therapy for
left main coronary artery ( LMCA) stenosis. Improvements in angioplasty and coronary stent techniques and equipment warrant a reappraisal of angioplasty in LMCA stenosis.

Objectives: To assess in-hospital and six-month clinical outcomes after stenting of unprotected left main coronary artery (LMCA) stenosis.

Methodology: Prospective study in a tertiary center of interventional cardiology and cardiac surgery for 64 patients with unprotected LMCA stenosis who were treated with bare-metal stents and underwent angiographic follow-up at 3 and months following the intervention.

Results: The procedural success rate was 100% with no episodes of acute or subacute stent thrombosis. in-stent restenosis rate was 15.6% and 15.9% in the first 3 and 6 months respectively. Six month mortality was nil.

Conclusion: Stenting of unprotected LMCA stenosis deserves to be considered a safe and effective alternative to CABG in carefully selected patients

Recommendation: Larger series should clarify whether unprotected LMCA stenting has the same favorable results as CABG .