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Outcomes of Percutaneous Coronary Interventions for Left Main Coronary Artery Stenoses at a Hospital
並列摘要
Background: According to the American College of Cardiology/American Heart Association guidelines, percutaneous coronary intervention (PCI) for left main coronary artery (LMCA) stenosis is contraindicated unless the patient is not eligible for coronary artery bypass graft surgery (CABG). The aim of this study was to analyze the immediate and late outcomes of PCIs for unprotected left main coronary stenoses at the Tri-Services General Hospital, Taipei, Taiwan. Methods: Design: Retrospective follow-up study. Patients: Seventeen patients were enrolled in the study between October 2002 and March 2005. Eleven patients presented with stable angina and underwent the procedure electively and six patients presented with acute coronary syndrome and received the procedure emergently. Interventions: Two patients received balloon dilatation only. Express Stents (Boston Scientific, United States) were used in ten patients, four patients received Taxus Express2 paclitaxel-eluting stents (Boston Scientific, United States), and one received an R stent (Orbus Medical Technologies, Netherlands). Main outcome measures: Procedural success rate and major cardiac events. Results: Intervention was successful in 16 of 17 patients. One emergent procedure failed because of total occlusion of the LMCA followed by cardiogenic shock. No immediate complications during the procedures or major cardiac events were detected in successfully treated patients. There were two noncardiac deaths during hospitalization. During the late follow-up period (mean, 20.2 months), no major adverse cardiac events occurred. Five patients received repeated coronary angiography and there were no recurrences of significant stenoses in previously treated left main coronary arteries. Conclusions: Elective stenting of an unprotected LMCA stenosis should be considered as a feasible, safe, and effective approach for treatment of appropriate lesions.
延伸閱讀
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