Long-term follow-up after drug eluting stent implantation in left main trifurcations.
OBJECTIVE
Trifurcation lesions, which are mostly observed in distal left main (LM), represent a technical challenge for interventional cardiologists. We sought to determine the feasibility and long-term clinical outcome of drug eluting stent (DES) implantation in patients with LM coronary trifurcation lesions.


RESULTS
All patients with clinically significant de novo LM trifurcation lesions, who refused coronary artery bypass surgery and were considered eligible for percutaneous coronary intervention (PCI), were consecutively enrolled in this study from November 2005 to February 2007. Eleven patients (65+/-9 years, 91% men) met all the inclusion criteria and underwent LM trifurcation stenting with DES. Angiographic success was 100%. Clinical follow-up in all patients and angiographic follow-up in 91% of patients was available at 32+/-7 and 8+/-2 months, respectively. The primary endpoint, defined as the composite of cardiac death or acute myocardial infarction, occurred in one patient (9%). No cases of stent thrombosis were recorded. Three patients (27%), experienced a clinically-driven target lesion revascularisation (TLR).


CONCLUSIONS
PCI with DES implantation in patients with LM trifurcation seems feasible and safe, with acceptable TLR rates. Large scale multicentre registries are warranted to reliably address clinical outcome of this subset of patients.
Tamburino
Corrado
C
Department of Internal Medicine and Systemic Disease, Ferrarotto Hospital, University of Catania, Catania, Italy.
Tomasello
Salvatore Davide
SD
Capodanno
Davide
D
Di Salvo
Maria Elena
ME
Marzà
Francesco
F
Ruggero Galassi
Alfredo
A
D000368:Aged; D017130:Angioplasty / Q000009:adverse effects*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000188:drug therapy*; D003331:Coronary Vessels / Q000473:pathology*; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage / Q000627:therapeutic use; D020123:Sirolimus / Q000008:administration & dosage / Q000627:therapeutic use; D050257:Tubulin Modulators / Q000008:administration & dosage / Q000627:therapeutic use
D007166:Immunosuppressive Agents; D050257:Tubulin Modulators; D017239:Paclitaxel; D020123:Sirolimus