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Abstract
Stenosis of left main coronary artery is of critical prognostic
importance. LMCA disease poses special magnagement problems
due to the extensive myocardial territory at risk during the
revascularization procedure.
Since the introduction of PTCA, intervention of the LMCA
has been an attractive target. However, the actue catastrophic
emergencies of dissection with abrupt vessel closure and the high
restenosis rate has been the major probelms with this procedure.
with the advant of newer interventional devices, particularly the
coronary stent, the risk of acute closure has been significantly
reduced and therefore there has been a renewed interest in
percutaneous intervention, for LMCA diseases.
The aim of this study ws to evaluate immediate and medium
term outcomes of stenting as a therpay for LMCA disease.
We studied twenty seven patients with significant LMCA
stenosis (> 50%) who were treated by PTCA and stenting.
Eighteen patients had unprotected LMCA and nine patients had
protected LMCA. Four patients were treated on an emergency
base and the other cases on an elective base.
Summary
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The procedural success was excellent for elective procedures
with no periprocedural coplications. The restenosis rate was
22.2%.
Poor outcome correlate in this study was due to emergency procedure, distal location of the lesion, unprotected LMCA, and higher postoperative stenosis percent.