Lesion regression after percutaneous coronary intervention for unprotected left main trunk disease.
BACKGROUND
Although some studies have documented the six-month angiographic outcomes of percutaneous coronary intervention (PCI) with new devices for unprotected left main trunk disease (ULMTD), a long-term angiographic analysis is mandatory to evaluate the safety and effectiveness of this procedure. This study aims to assess a long-term (one year or more) angiographic analysis after PCI for this lesion.


METHODS
PCI was performed for 225 ULMTD with de novo or restenotic lesions. There were 19 deaths and 12 repeat PCIs during the hospital stay. The remaining 194 lesions were followed, and 126 lesions showed no angiographic restenosis or target lesion revascularization within six months. Finally, long-term quantitative angiographic follow-up was completed in 78 lesions (mean 2.4 years, maximum 7.5 years after PCI).


RESULTS
Minimal lumen diameter increased significantly from 2.46 +/- 0.59 mm to 2.72 +/- 0.65 mm (p < 0.0001) and percent diameter stenosis decreased significantly from 26 +/- 14% to 19 +/- 14% (p < 0.0001) between the six-month and the long-term follow-ups. No additional restenosis or new lesions were found at long-term follow-up, and significant lesion regression was ascertained in each procedure (directional coronary atherectomy, p < 0.005; ballooning, p < 0.005; stenting, p < 0.05).


CONCLUSIONS
These findings support the safety and effectiveness of PCI for ULMTD during the long-term period.
Kosuga
Kunihiko
K
Department of Cardiology, Shiga Medical Center for Adults, Japan.
Tamai
Hideo
H
Kyo
Eisho
E
Hata
Tatsuhiko
T
Okada
Masaharu
M
Nakamura
Takuji
T
Fujita
Shinya
S
Tsuji
Takafumi
T
Takeda
Shinsaku
S
Inuzuka
Yasutaka
Y
Motohara
Seiichiro
S
Uehata
Hiromu
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy*; D023921:Coronary Stenosis / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D013997:Time Factors; D016896:Treatment Outcome