Late and very late stent thrombosis following drug-eluting stent implantation in unprotected left main coronary artery: a multicentre registry.
OBJECTIVE
To evaluate the occurrence of late and very late stent thrombosis (ST) following elective drug-eluting stent (DES) implantation in unprotected left main coronary artery (LMCA) stenosis in a large multicentre registry.


RESULTS
All 731 consecutive patients who had sirolimus- or paclitaxel-eluting stent electively implanted in de novo lesions on unprotected LMCA in five centres were included. ST was defined according to Academic Research Consortium definitions. Four (0.5%) patients had a definite ST: three early (two acute and one subacute) and one late ST, no cases of very late definite ST were recorded. All patients survived from the event. Three patients had a probable ST. Therefore, 7/731 (0.95%) patients had a definite or a probable ST and all were on dual antiplatelet therapy at the time of the event. Possible (eight late and 12 very late) ST occurred in 20 (2.7%) patients. At 29.5 ± 13.7 months follow-up, a total of 45 (6.2%) patients had died; 31 (4.2%) of cardiac death. Ninety five (12.9%) patients had a target-vessel and 76 (10.4%) a target-lesion revascularization. Angiographic follow-up was performed in 548 patients (75%): restenosis occurred in 77 (14.1%) patients.


CONCLUSIONS
Elective treatment of LMCA stenosis with DES appears safe with a 0.9% incidence of definite and probable ST at 29.5 ± 13.7 months.
San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy.
Alaide
A
Chieffo
Seung-Jung
SJ
Park
Emanuele
E
Meliga
Imad
I
Sheiban
Michael S
MS
Lee
Azeem
A
Latib
Young-Hak
YH
Kim
Marco
M
Valgimigli
Dario
D
Sillano
Valeria
V
Magni
Giuseppe
G
Biondi-Zoccai
Matteo
M
Montorfano
Flavio
F
Airoldi
Renata
R
Rogacka
Mauro
M
Carlino
Iassen
I
Michev
Cheol-Whan
CW
Lee
Myeong-Ki
MK
Hong
Seong-Wook
SW
Park
Claudio
C
Moretti
Erminio
E
Bonizzoni
Giuseppe M
GM
Sangiorgi
Jonathan
J
Tobis
Patrick W
PW
Serruys
Antonio
A
Colombo
D000368:Aged; D023903:Coronary Restenosis / Q000517:prevention & control*; D054855:Drug-Eluting Stents; D005260:Female; D006083:Graft Occlusion, Vascular / Q000209:etiology*; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000379:methods; D017239:Paclitaxel / Q000008:administration & dosage*; D012042:Registries; D020123:Sirolimus / Q000008:administration & dosage*; D016896:Treatment Outcome; D050257:Tubulin Modulators / Q000008:administration & dosage*
D050257:Tubulin Modulators; D017239:Paclitaxel; D020123:Sirolimus