Elective sirolimus‐eluting stent implantation for left main coronary artery disease: Six‐month angiographic follow‐up and 1‐year clinical outcome

Arampatzis, Chourmouzios A.; Lemos, Pedro A.; Hoye, Angela; Saia, Francesco; Tanabe, Kengo; Giessen, Willem J. van der; Smits, Pieter C.; McFadden, Eugène; Feyter, Pim de; Serruys, Patrick W.

doi:10.1002/ccd.20064

Cited by 42 publications

(20 citation statements)

References 86 publications

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“…9 -13 A single-center observational study recently reported encouraging results with the treatment of left main stenosis, either protected or unprotected, with SES. 14,15 No data are available on the use of PES in ULM disease. To provide insight into this controversial field, we report our experience with elective DES implantation in lesions involving the ULM.…”

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confidence: 99%

Early and Mid-Term Results of Drug-Eluting Stent Implantation in Unprotected Left Main

et al. 2005

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confidence: 99%

Early and Mid-Term Results of Drug-Eluting Stent Implantation in Unprotected Left Main

et al. 2005

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“…However, in-stent restenosis remains one of the principal limitations inherent in this therapy, and restenosis in the LMCA is considered to be more dangerous than in any other coronary lesions. Several small reports from single centers have revealed the safety and the effectiveness of drug-eluting stents, most notably sirolimus-eluting stents (SES), in these lesions [3,4,5,6]. The initial data from these reports are encouraging.…”

Section: Introductionmentioning

confidence: 48%

Sirolimus- versus Paclitaxel-Eluting Stent Implantation for Unprotected Left Main Coronary Artery Stenosis

Lee

Jang

et al. 2005

Cardiology

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We performed this study in order to compare the immediate and mid-term outcomes of sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES) in lesions of the unprotected left main coronary artery (LMCA). We assessed 54 patients from 5 centers who had undergone unprotected LMCA stenting (35 SES and 19 PES). The procedural success rates were 100 and 95%, respectively, in the SES and PES patients (p = 0.19). At the 6-month clinical follow-up, the event-free probability was 100% in the SES group, and 88% in the PES group (p = 0.07). At the 6-month angiographic follow-up (n = 24), the SES group exhibited a slightly lower late loss than did the PES group (0.24 ± 0.44 vs. 0.65 ± 0.60 mm, p = 0.09), and the restenosis rates were 8 and 9% (p = 0.94) in the SES and PES patients, respectively. In conclusion, both groups exhibited excellent in-hospital and 6-month outcomes with no significant differences between them.

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“…High mortality risk scores (EuroSCORE ≥ 6 and/or Parsonnet ≥ 15) 13 were present Table 2 summarizes quantitative coronary angiographic data. Although a greater number of diseased vessels were present in group 2 as compared to group 1, the numbers of vessels subjected to intervention were not significantly different between the 2 groups (Table 3).…”

Section: Resultsmentioning

confidence: 99%

Two‐Year Outcomes of the Sirolimus‐Eluting Stent According to Unprotected Left Main Lesion

Kim

Park

Seol

et al. 2009

Clinical Cardiology

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Background: The data of long-term outcomes of sirolimus-eluting stent (SES) according to lesion location of unprotected left main coronary artery (LMCA) is scarce. Hypothesis: The purpose of this study was to evaluate the long-term outcomes after implantation of the SES in LMCA. Methods: A total of 84 patients (51 males) who had undergone SES implantation for the treatment of native LMCA stenosis were enrolled. The patients were divided into 2 groups based on angiographic lesion location: those with significant stenosis in the ostium and/or body (group 1; n = 39) and those involving bifurcation (group 2; n = 45). Results: All of the group 1 patients were treated with simple lesion coverage while different stenting techniques were used in group 2 (cross-over: 44.8%, T: 6.7%, kissing: 37.8%, and crush techniques: 11.1%). The 8-month quantitative angiographic findings and in-hospital and 2 year rates of major adverse cardiac events (MACE) were compared between the 2 groups. Although angiographic success and in-hospital MACE rates were similar in both groups with 1 cardiac death due to acute stent thrombosis in group 2, at 2-year follow-up, the MACE rate was significantly higher in group 2 than in group 1 at 2 years (22.2% vs 2.6%, respectively, P = 0.008). Coronary angiography revealed a significantly higher binary restenosis rate in group 2 compared with group 1 (20% vs 0%, respectively, P = 0.003). Conclusions: Interventional treatment using SES in left main lesions showed favorable short-term and longterm outcomes in selected patients with lesion location being an important determinant of clinical and angiographic outcomes. IntroductionPercutaneous coronary intervention (PCI) with drug-eluting stent (DES) has been associated with marked reductions in restenosis rates 1 and neointimal hyperplasia formation; 2 this also appears to be the case for the treatment of unprotected left main coronary artery (LMCA) lesions, 3 -5 an observation that stands in contrast with the fact that in the bare-metal stent era an LMCA lesion was a definite indication for coronary artery bypass graft (CABG) surgery. However, there is little data on the long-term outcomes according to LMCA lesion complexity and location and therefore this registry study was aimed at evaluating long-term clinical and angiographic outcomes according to LMCA lesion location post sirolimus-eluting stent (SES) implantation.

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Elective sirolimus‐eluting stent implantation for left main coronary artery disease: Six‐month angiographic follow‐up and 1‐year clinical outcome

Cited by 42 publications

References 86 publications

Early and Mid-Term Results of Drug-Eluting Stent Implantation in Unprotected Left Main

Early and Mid-Term Results of Drug-Eluting Stent Implantation in Unprotected Left Main

Sirolimus- versus Paclitaxel-Eluting Stent Implantation for Unprotected Left Main Coronary Artery Stenosis

Two‐Year Outcomes of the Sirolimus‐Eluting Stent According to Unprotected Left Main Lesion

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