Favorable long-term outcome after drug-eluting stent implantation in nonbifurcation lesions that involve unprotected left main coronary artery: a multicenter registry

Circulation. 2007 Jul 10;116(2):158-62. doi: 10.1161/CIRCULATIONAHA.107.692178. Epub 2007 Jun 18.


Background: The presence of a lumen narrowing at the ostium and the body of an unprotected left main coronary artery but does not require bifurcation treatment is a class I indication of surgical revascularization.

Methods and results: A total of 147 consecutive patients who had a stenosis in the ostium and/or the midshaft of an unprotected left main coronary artery (treatment of the bifurcation not required) and were electively treated with percutaneous coronary intervention and sirolimus-eluting stents (n=107) or paclitaxel-eluting stents (n=40) in 5 centres were included in this registry. In 72 patients (almost 50%), intravascular ultrasound guidance was performed. Procedural success was achieved in 99% of the patients; in 1 patient with stenosis in the left main coronary artery ostium, a >30% residual stenosis persisted at the end of the procedure, and the patient was referred for coronary artery bypass graft surgery. During hospitalization, no patients experienced a Q-wave myocardial infarction or died. One patient died 19 days after the procedure because of pulmonary infection. At long-term clinical follow-up (886+/-308 days), 5 patients had died; 7 patients had target vessel revascularization (5 repeat percutaneous coronary interventions and 2 coronary artery bypass graft surgeries), and of these only 1 patient had a target lesion revascularization. Angiographic follow-up was performed in 106 patients (72%) with a late loss of -0.01 mm. Restenosis in the left main trunk occurred only in 1 patient (0.9%).

Conclusions: Percutaneous coronary intervention with sirolimus-eluting stents or paclitaxel-eluting stents implantation in nonbifurcation left main coronary artery lesions appears safe with a long-term major adverse clinical event rate of 7.4% and a restenosis rate of 0.9%.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Angina, Unstable / epidemiology
  • Coronary Artery Bypass / statistics & numerical data
  • Coronary Disease / mortality
  • Coronary Disease / surgery*
  • Diabetic Angiopathies / epidemiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Registries
  • Safety
  • Stents* / adverse effects
  • Survival Analysis
  • Treatment Outcome
  • Ventricular Dysfunction, Left / epidemiology