title: Safety and technical success of percutaneous left main coronary artery stenting.
abstract: OBJECTIVE
  Critical stenosis of left main coronary artery (LMCA) has always remained a challenge for interventional cardiologists. Conventionally Coronary Artery Bypass Grafting (CABG) is done for these patients but recently Percutaneous Coronary Intervention (PCI) is also being tried more frequently, but data of PCI is scarce in this regard. Our objective was to determine the safety and technical success rate of percutaneous left main coronary artery stenting.
  
  
  METHODS
  This was 12 month follow up study conducted at Pakistan Institute of Medical Sciences (PIMS), Islamabad from 11(th) Jan 2012 to 11(th) Jan 2013. All symptomatic patients who underwent coronary angiogram at PIMS and were found to have either isolated LMCA disease or coexisting osteal Left Anterior Descending (LAD) artery disease were potentially eligible for the study. Patients who had previous surgical treatment for coronary artery disease and those with renal dysfunction requiring dialysis were excluded. Patients were counselled in detail regarding the pros and cons of PCI versus CABG.Those who opted for PCI were included in the study. All these patients were treated with percutaneous left main coronary artery stenting with or without osteal LAD stenting.
  
  
  RESULTS
  Seventy two patients had LMCA disease during angiogram. Fifteen patients opted for CABG. Four patients did not meet the inclusion criteria, whereas 53 patients were finally enrolled. Mean age of patients were 55.45±10.275 years. Twenty nine patients were with acute coronary syndrome and 22 presented with unstable angina.PCI with stenting was technically successful in all patients. One patient died three months after PCI, there was no other mortality.
  
  
  CONCLUSIONS
  Our study showed that Percutaneous Coronary Intervention (PCI) to LMS has good technical success rate; the safety of the procedure is also acceptable.
authors.affiliation: Liaqat Ali, FCPS (Medicine), Department of Cardiology, Pakistan Institute of Medical Sciences, Islamabad, Pakistan.
authors.forename: Liaqat
authors.initials: L
authors.lastname: Ali
authors.affiliation: Shahid Nawaz Malik, MRCP, Interventional cardiologist, Head of Department of Cardiology, Department of Cardiology, Pakistan Institute of Medical Sciences, Islamabad, Pakistan.
authors.forename: Shahid Nawaz
authors.initials: SN
authors.lastname: Malik
authors.affiliation: Abdullah Bin Khalid, Dow University of Health Sciences, Karachi, Pakistan.
authors.forename: Abdullah Bin
authors.initials: AB
authors.lastname: Khalid
authors.affiliation: Mehboob Sultan, FCPS (Pediatrics), AFIC/NIHD. Rawalpindi, Pakistan. Armed Forces Institute of Cardiology & National Institute of Heart Diseases AFIC/NIHD, Rawalpindi, Pakistan.
authors.forename: Mehboob
authors.initials: M
authors.lastname: Sultan
authors.affiliation: Nadeem Sadiq, FCPS (Pediatrics), Armed Forces Institute of Cardiology & National Institute of Heart Diseases AFIC/NIHD, Rawalpindi, Pakistan.
authors.forename: Nadeem
authors.initials: N
authors.lastname: Sadiq
keywords: Coronary artery bypass graft; Left main coronary artery
references.citation: Thromb Haemost. 2008 Jun;99(6):991-2
references.pmid: 18521497
references.citation: J Am Coll Cardiol. 2008 Feb 5;51(5):538-45
references.pmid: 18237682
references.citation: Am Heart J. 2008 Feb;155(2):274-83
references.pmid: 18215597
references.citation: J Coll Physicians Surg Pak. 2007 Jan;17(1):3-7
references.pmid: 17204210
references.citation: Circulation. 2004 Oct 5;110(14):e340-437
references.pmid: 15466654
references.citation: Circ J. 2007 Jun;71(6):855-61
references.pmid: 17526980
references.citation: Circulation. 2005 Feb 15;111(6):791-5
references.pmid: 15699254
references.citation: Circulation. 2006 Feb 21;113(7):e166-286
references.pmid: 16490830
references.citation: Eur Heart J. 2012 Jan;33(1):36-50b
references.pmid: 22210689
references.citation: Curr Probl Cardiol. 2007 Mar;32(3):103-93
references.pmid: 17382834
references.citation: J Am Coll Cardiol. 2009 Oct 20;54(17):1576-88
references.pmid: 19833256
references.citation: Neth Heart J. 2002 Oct;10(10):395-398
references.pmid: 25696034
references.citation: J Am Coll Cardiol. 2011 Sep 27;58(14):1426-32
references.pmid: 21939824
references.citation: Am J Cardiol. 2012 Dec 15;110(12):1764-72
references.pmid: 23078911
references.citation: J Invasive Cardiol. 2013 Jan;25(1):23-7
references.pmid: 23293171
references.citation: JACC Cardiovasc Interv. 2008 Jun;1(3):236-45
references.pmid: 19463306
references.citation: JACC Cardiovasc Interv. 2010 Jun;3(6):602-11
references.pmid: 20630453
references.citation: JACC Cardiovasc Interv. 2009 Aug;2(8):739-47
references.pmid: 19695542
references.citation: Catheter Cardiovasc Interv. 2006 Sep;68(3):357-62
references.pmid: 16892431
references.citation: J Am Coll Cardiol. 2006 Feb 21;47(4):864-70
references.pmid: 16487857
references.citation: J Am Coll Cardiol. 2006 Feb 21;47(4):871-7
references.pmid: 16487858
references.citation: N Engl J Med. 2009 Mar 5;360(10):961-72
references.pmid: 19228612
references.citation: EuroIntervention. 2011 Oct 30;7(6):738-46, 1
references.pmid: 21947626
references.citation: Proc (Bayl Univ Med Cent). 2007 Oct;20(4):339-43
references.pmid: 17948103