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Percutaneous Coronary Intervention for Unprotected Left Main Coronary Artery Lesions
| Content Provider | Semantic Scholar |
|---|---|
| Author | Quizhpe, Arturo Ricardo Ortega, César Vázquez, Xavier A. Astudillo, Adriana Salto, Ender Córdova, Diego |
| Copyright Year | 2010 |
| Abstract | Background: Refinements in percutaneous coronary intervention (PCI), including the use of intravascular ultrasound (IVUS) and fractional flow reserve (FFR), have allowed the treatment of complex lesions with good results. As a result, the percutaneous approach for left main coronary artery (LM) lesions has spread, including centers with a lower volume of PCI procedures. Our objective was to report the early and late outcomes of PCI in unprotected LM lesions. Methods: Consecutive patients treated at two different hospitals from August 2009 to July 2013 were included. The indication for the percutaneous approach was based on the clinical assessment and the calculation of Syntax score, EuroScore and on the patient’s wishes. Results: Twenty-eight patients with mean age of 69.2 ± 10.1 years were treated, 39% were diabetic and 39% had acute coronary syndromes. Half of the patients had EuroScore ≥ 6; the Syntax score was 26.0 ± 8.4 and 82% had LM bifurcation lesions. Interventions were guided by IVUS and/or FFR in 71.4% of the patients, 93% were treated with drug-eluting stents, and the 1-stent technique was used in most occasions. Angiographic success was achieved in 100% of the cases. At the 19.2 ± 13.7 month follow-up, the rate of major adverse cardiac events was 21.4% in the follow-up longer than 4 years, cardiac death 14.2%, non-fatal myocardial infarction 3.5% and target-lesion revascularization 3.5%. Conclusions: PCI in unprotected LM lesions, guided by IVUS and/or FFR whenever possible, is safe and effective in the short and long-term, in the experience of a hospital with a moderate number of PCI procedures. DESCRIPTORS: Coronary artery disease. Coronary stenosis. Percutaneous coronary intervention. Drug-eluting stents. Ultrasonics. 1 Chief, Department of Hemodynamics, Hospital José Carrasco Arteaga. Cuenca, Ecuador. 2 Cardiologist, Hospital José Carrasco Arteaga. Cuenca, Ecuador. 3 Echocardiographist, Hospital José Carrasco Arteaga and Hospital Santa Inés. Cuenca, Ecuador. 4 Chief, Department of Cardiology, Hospital José Carrasco Arteaga. Cuenca, Ecuador. 5 Echocardiographist, Hospital Santa Inés. Cuenca, Ecuador. 6 Cardiologist, Hospital Santa Inés. Cuenca, Ecuador. 7 Physician, General Practitioner, Department of Hemodynamics, Hospital Santa Inés. Cuenca, Ecuador. 8 Image Technician, Department of Hemodynamics, Hospital José Carrasco Arteaga. Cuenca, Ecuador. 9 Image Technician, Department of Hemodynamics, Hospital José Carrasco Arteaga. Cuenca, Ecuador. 10 Cardiac Surgeon, Chief, Department of Hemodynamics, Hospital Santa Inés. Cuenca, Ecuador. Correspondence: Arturo Ricardo Quizhpe. Unidad de Hemodinámica del Hospital José Carrasco Arteaga. Popayan y Pacto Andino. Cuenca, Ecuador. E-mail: riquizimo@yahoo.es Received: 7/18/2013 • Accepted:09/11/2013 Original Article |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | https://core.ac.uk/download/pdf/81960262.pdf |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Accident and Emergency department Acute Coronary Syndrome Adverse reaction to drug Arteriopathic disease Artificial cardiac pacemaker Bifurcation theory Cardiac Death Chromosome Deletion Conflict (Psychology) Coronary Artery Disease Coronary Stenosis Diabetes Mellitus Drug-Eluting Stents Email Follow-Up Report Fractional Flow Reserve of Vessel Hemodynamics Intravascular ultrasound Left coronary artery structure Myocardial Infarction Patients Percutaneous Coronary Intervention Stent, device Ultrasonics (sound) levomefolate calcium revascularization |
| Content Type | Text |
| Resource Type | Article |
