Unprotected left main coronary artery percutaneous coronary intervention

In-hospital and long-term evolution of a single center

Abstract

Unprotected left coronary artery angioplasty is, since recent years, a valid alternative for the treatment of obstructive lesions of the left main coronary artery. Objectives: To evaluate the rates of cardiac death, acute myocardial infarction, stroke, coronary left main revascularization and the composite of major cardiovascular events, from patients undergoing Percutaneous Transluminal Angioplasty with stent placement on atherosclerotic lesions that compromise unprotected left main coronary artery. Material and Methods: We examined during the in-hospital phase, at one year and during a distant follow-up, a total of 66 patients from December 2006 to December 2016 undergoing the above described procedure with a mean follow-up of 3.6 ± 1.7 years. Results: Patients had an in-hospital evolution with an average cardiac death rate of 3%. The rate of acute myocardial infarction was 3% and the total rate of major cardiovascular events was 6%. After 1 year, the rate of major cardiovascular events was 10.2% (Cardiac Death 2.5% - Acute Myocardial Infarction 2.6% - Left Main Revascularization 5.1%). In the follow-up period the total rate of cardiovascular events was 27.7% (Left Main Revascularization 6.1% - Cardiac Deaths 9.1% - Stroke 9.4% - Acute Myocardial Infarction 3.1%). Conclusions: The results of this study indicate acceptable rates of complications in patients who underwent percutaneous transluminal angioplasty with stenting on obstructive lesions of the unprotected left main coronary artery.