title: Bare metal stent implantation in large-sized unprotected left main coronary artery stenosis in the drug-eluting stent era.
abstract: Recently, drug-eluting stent (DES) has been recommended as the first choice in those patients who need stent implantation in unprotected left main coronary artery (ULMCA) stenosis. However, the long-term safety and efficacy of this procedure is still controversial. The objective of this study was to evaluate the safety and efficacy of bare metal stent (BMS) implantation in ULMCA stenting in the DES era. We implanted BMS (mainly 4 mm-diameter) in large-sized ULMCA after December 2004 when DES became available. The results of BMS implantation (n = 19) were compared with those of DES implantation (n = 39). There was no significant difference between the 2 groups regarding age, gender and coronary risk factors. Emergency procedures were more frequently performed in the BMS group than in the DES group (53% vs. 26%, p = 0.08). The initial mortality was 10.5% (n = 2) in the BMS group and 2.6% (n = 1) in the DES group (p = 0.25). There was no stent thrombosis, Q-wave myocardial infarction or emergent bypass surgery in either group during their hospital stay. The restenosis rate was 0% (n = 45) in both groups, and the target vessel revascularization rate was 5.9% in the BMS group (1/17) and 2.6% (1/38) in the DES group (p = 0.53). Therefore, there were no statistically significant differences in outcomes between the two study groups. These results indicate that BMS implantation in a large-sized ULMCA may be a safe and effective treatment even in the DES era.
authors.affiliation: Department of Cardiology, Shiga Medical Center for Adults, 5-4-30, Moriyama, Moriyama, Shiga, Japan, JCH02462@nifty.com.
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Kosuga
authors.forename: Masaharu
authors.initials: M
authors.lastname: Okada
authors.forename: Shinsaku
authors.initials: S
authors.lastname: Takeda
authors.forename: Tatuhiko
authors.initials: T
authors.lastname: Hata
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Takeuchi
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Kawata
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Ishii
authors.forename: Kenshi
authors.initials: K
authors.lastname: Harita
authors.forename: Soji
authors.initials: S
authors.lastname: Nishio
authors.forename: Shigeru
authors.initials: S
authors.lastname: Ikeguchi
authors.forename: Eisho
authors.initials: E
authors.lastname: Kyo
authors.forename: Takafumi
authors.initials: T
authors.lastname: Tsuji