title: Favorable long-term outcome after drug-eluting stent implantation in nonbifurcation lesions that involve unprotected left main coronary artery: a multicenter registry.
abstract: 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.
  
  
  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%.
authors.affiliation: San Raffaele Scientific Institute and Emo Centro Cuore Columbus, Via Olgettina 60, 20132 Milan, Italy.
authors.forename: Alaide
authors.initials: A
authors.lastname: Chieffo
authors.forename: Seung J
authors.initials: SJ
authors.lastname: Park
authors.forename: Marco
authors.initials: M
authors.lastname: Valgimigli
authors.forename: Young H
authors.initials: YH
authors.lastname: Kim
authors.forename: Joost
authors.initials: J
authors.lastname: Daemen
authors.forename: Imad
authors.initials: I
authors.lastname: Sheiban
authors.forename: Alessandra
authors.initials: A
authors.lastname: Truffa
authors.forename: Matteo
authors.initials: M
authors.lastname: Montorfano
authors.forename: Flavio
authors.initials: F
authors.lastname: Airoldi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Sangiorgi
authors.forename: Mauro
authors.initials: M
authors.lastname: Carlino
authors.forename: Iassen
authors.initials: I
authors.lastname: Michev
authors.forename: Cheol W
authors.initials: CW
authors.lastname: Lee
authors.forename: Myeong K
authors.initials: MK
authors.lastname: Hong
authors.forename: Seong W
authors.initials: SW
authors.lastname: Park
authors.forename: Claudio
authors.initials: C
authors.lastname: Moretti
authors.forename: Erminio
authors.initials: E
authors.lastname: Bonizzoni
authors.forename: Renata
authors.initials: R
authors.lastname: Rogacka
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
authors.forename: Antonio
authors.initials: A
authors.lastname: Colombo
mesh_terms: D000368:Aged; D000789:Angina, Unstable / Q000453:epidemiology; D001026:Coronary Artery Bypass / Q000706:statistics & numerical data; D003327:Coronary Disease / Q000401:mortality / Q000601:surgery*; D003925:Diabetic Angiopathies / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012042:Registries; D012449:Safety; D015607:Stents / Q000009:adverse effects; D016019:Survival Analysis; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000453:epidemiology