title: Long-term outcomes following drug-eluting stent implantation in unprotected left main bifurcation lesions.
abstract: BACKGROUND
  The safety and efficacy of drug-eluting stents (DES) implantation in unprotected left main (LM) bifurcation lesions has yet to be determined. The aim of the present report was to evaluate the long-term outcome following implantation of DES in unprotected LM bifurcation lesions.
  
  
  METHODS
  We identified 70 consecutive patients treated with DES in unprotected LM bifurcation lesions from April 2003 to January 2005. Of them, 42 patients were treated with sirolimus-eluting stent (SES) and 28 patients were treated with paclitaxel-eluting stent (PES).
  
  
  RESULTS
  Stents to the left anterior descending and to the circumflex were implanted in 62 patients. During 1-year follow-up, 3 (4.3%) patients died of cardiac causes. One of them had myocardial infarction and adjudicated as possibly due to stent thrombosis. Angiographic follow-up was available in 80% of patients. The per lesion restenosis rate was 13.4% in the entire cohort, of which 10.7% occurred in lesions treated with SES and 16.1% in those treated with PES (P = 0.58). All restenosis was focal and occurred in the lesions treated with a stent with stent size to post-procedural reference vessel diameter ratio < 1.0 (17.6% vs 0, P = 0.04). The per patient target lesion revascularization rate at 1 year was 17.1%. One year survival free from major adverse cardiac events was 77.1%.
  
  
  CONCLUSIONS
  Treatment of LM bifurcation lesions using DES is a safe and feasible way with a low one-year mortality. The need for revascularization in 17% of patients demands for improvement.
authors: Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, Shanghai 200032, China.
authors: Lei
authors: L
authors: Ge
authors: John
authors: J
authors: Cosgrave
authors: Ioannis
authors: I
authors: Iakovou
authors: Ju-ying
authors: JY
authors: Qian
authors: Pierfrancesco
authors: P
authors: Agostoni
authors: Giuseppe M
authors: GM
authors: Sangiorgi
authors: Flavio
authors: F
authors: Airoldi
authors: Iassen
authors: I
authors: Michev
authors: Alaide
authors: A
authors: Chieffo
authors: Nicola
authors: N
authors: Corvaja
authors: Antonio
authors: A
authors: Colombo
authors: Jun-bo
authors: JB
authors: Ge
mesh_terms: D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000401:mortality / Q000628:therapy*; D023903:Coronary Restenosis / Q000517:prevention & control; D016503:Drug Delivery Systems; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D017239:Paclitaxel / Q000008:administration & dosage*; D020123:Sirolimus / Q000008:administration & dosage*; D015607:Stents
chemical_list: D017239:Paclitaxel; D020123:Sirolimus