[One-stage PCI of left main stenosis and infarct-related left main major branches in STEMI patients].
OBJECTIVE
to determine immediate and long-term results, safety and efficacy of one-stage PCI of LMCA and infarct-related LAD or CxA in STEMI.


METHODS
81 patients with STEMI treated with one-stage PCI of LMCA and infarct-related LAD or CxA were included into the study. LAD was infarct-related in 53 (65.4%) patients, circumflex (CxA) involved in 28 (34.6%) cases. Distal LMCA lesion was in 45 patients (55.6%).


RESULTS
All patients were treated with drug-eluting stents. Radial access was used in 66 (81.4%) cases, in 38 (46.9%) patients intra-aortic balloon contrapulsation supported the procedure. IVUS was performed in 19 (23.4%) patients. Mortality during the procedure was 2.5% (2 patients with cardiogenic shock owing to infarct-related LAD). All other cases were technically successful. Two more patients died during the hospitalization, so short-term mortality was 4.9%. Angina symptoms persisted in 27 patients (33.3%) and were due to lesions in other coronary arteries. In these cases, the second PCI was performed. The mean follow-up period was 32-39 months. During follow-up 7 patients (8.6%) died due to various reasons. Target lesion revascularization was performed in 10 (12.3%) patients, including 3 repeated PCI of LMCA. Repeated revascularization due to atherosclerosis progression in other segments was done in 11 (13.5%) patients. MACCE-free survival was 60.7%.


CONCLUSIONS
one-stage PCI of LMCA and infarct-related LAD or CxA seems to be effective and safe treatment in patients with STEMI but larger studies with prolonged follow-up are needed.
E V
EV
Merkulov
A N
AN
Samko
V M
VM
Mironov
D V
DV
Pevzner
E V
EV
Shreĭder
M Ia
MIa
Ruda
D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D023921:Coronary Stenosis / Q000601:surgery / Q000628:therapy*; D003331:Coronary Vessels / Q000601:surgery*; D006801:Humans; D009203:Myocardial Infarction / Q000628:therapy*; D012426:Russia