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Stenting Left Main

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One or two stents for the distal Left Main bifurcation The DK crush V study - The DK crush V study Left Main Stenting: What We Have Learnt So Far? Comparison of double kissing crush versus Culotte stenting for unprotected distal left main bifurcation lesions: results from a multicenter, randomized, prospective DKCRUSH-III study The Current State of Left Main Percutaneous Coronary Intervention Novel developments in revascularization for left main coronary artery disease Provisional versus elective two-stent strategy for unprotected true left main bifurcation lesions: Insights from a FAILS-2 sub-study Left Main Bifurcation Angioplasty: Are 2 Stents One Too Many? Impact of coronary anatomy and stenting technique on long-term outcome after drug-eluting stent implantation for unprotected left main coronary artery disease 2-year outcomes with the Absorb bioresorbable scaffold for treatment of coronary artery disease: a systematic review and meta-analysis of seven randomised trials with an individual patient data substudy Design and rationale for the treatment effects of provisional side branch stenting and DK crush stenting techniques in patients with unprotected distal left main coronary artery bifurcation lesions (DKCRUSH V) Trial
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Clinical Trial2012 Oct 2;60(14):1217-22.

JOURNAL：J Am Coll Cardiol. Article Link

Clinical and angiographic outcomes of patients treated with everolimus-eluting stents or first-generation Paclitaxel-eluting stents for unprotected left main disease

Valenti R, Migliorini A, Parodi G et al. Keywords: drug-eluting stent(s); everolimus-eluting stent(s); paclitaxel-eluting stent(s)

ABSTRACT

OBJECTIVES - The goal of this study was to compare the outcomes of patients treated with everolimus-eluting stents (EES) with outcomes of patients treated with first-generation paclitaxel-eluting stents (PES) for unprotected left main disease (ULMD).


BACKGROUND - No data exist about the comparison of these 2 types of stents in ULMD.

METHODS - The primary endpoint of the study was a 1-year composite of cardiac death, nonfatal myocardial infarction, target vessel revascularization, and stroke (MACE). Secondary endpoints were 1-year target vessel failure (TVF) and 9-month angiographic in-segment restenosis >50%.

RESULTS - From 2004 to 2010, a total of 390 patients underwent ULMD percutaneous coronary intervention (224 received PES and 166 EES). The 1-year MACE rate was 21.9% in the PES group and 10.2% in the EES group (p = 0.002). TVF rate was 20.5% in the PES group and 7.8% in the EES group (p < 0.001). The in-segment restenosis rate was 5.2% in the EES group and 15.6% in the PES group (p = 0.002). EES and EuroSCORE were the only variables related to the risk of MACE. EES (odds ratio: 0.32; p = 0.007) was also independently related to the risk of restenosis.

CONCLUSIONS - EES implantation for ULMD is associated with a reduced incidence of 1-year MACE, TVF, and restenosis as compared with PES implantation.

Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
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