One-year results of unprotected left main disease treatment with paclitaxel-eluting stents: results of a multicenter registry.
BACKGROUND
Preliminary data suggest that drug-eluting stents might have a role in selected cases of unprotected left main stenosis (ULMS). The purpose of this study was to determine the rates of death, myocardial infarction, and repeated revascularization in a multicenter, prospective series of patients with ULMS treated with paclitaxel-eluting stents.


METHODS
A prospective registry was initiated in March 2003 through December 2004 in five tertiary centers including all patients with a significant (>50%) stenosis in ULMS treated with at least one paclitaxel-eluting stent. There were no clinical or angiographic exclusion criteria. Clinical follow-up was obtained at 6 and 12 months.


RESULTS
A total of 100 patients were included. Mean age was 67.6 +/- 11.4 years and 36% were diabetics. Distal left main was affected in 53% of patients. Implantation of two stents was required in only 15%. Angiographic success was achieved in all cases. Significant periprocedural CK-MB elevation occurred in 5 patients and there was 1 intraprocedural death. At a median 9 months follow-up, cardiac death occurred in 7%, the majority of which (4%) in patients with ST-elevation myocardial infarction and cardiogenic shock before stent implantation. Only 3 patients (3%) required repeated target-vessel revascularization, all repeated angioplasty procedures.


CONCLUSIONS
Percutaneous treatment of unprotected left main lesions with paclitaxel-eluting stents is associated with acceptable mid-term results in selected patients, with very low rates of repeated revascularization.
Sanmartin
Marcelo
M
Hospital do Meixoeiro, Meixoeiro s/n, CP 36200, Vigo, Spain. msanfer@telefonica.net
Baz
Jose Antonio
JA
Lozano
Iñigo
I
de la Torre
Jose Maria
JM
Hernandez
Jose Maria
JM
Bordes
Pascual
P
Mainar
Vicente
V
Mauri
Josepa
J
Iñiguez
Andrés
A
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000401:mortality; D019917:Blood Vessel Prosthesis Implantation; D020099:Coated Materials, Biocompatible / Q000627:therapeutic use*; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000401:mortality* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality / Q000628:therapy; D017239:Paclitaxel / Q000627:therapeutic use*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011183:Postoperative Complications / Q000401:mortality / Q000628:therapy; D011446:Prospective Studies; D012042:Registries; D012086:Reoperation; D012107:Research Design; D013030:Spain / Q000453:epidemiology; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome
D020099:Coated Materials, Biocompatible; D010975:Platelet Aggregation Inhibitors; D017239:Paclitaxel