Clinical Outcome After Drug-eluting Stent Implantation For The Percutaneous Treatment Of Unprotected Left Main Coronary Artery Disease

Objective:To evaluate the clinical outcome of 65 patients with unprotected left main of coronary artery(ULMCA) disease treated by drug-eluting stem implantation. Methods:From 2004,Jan.to 2007,Nov.,there were 65 patients with ULMCA stenosis(≥50%) who confirmed by coronary angiography(CAG) and implanted drug-eluting stent(DES).All of the patients were followed-up after percutaneous coronary intervention(PCI).We observe the MACE events including the cardiac death, the cardiac myocardial infarction,rehospitalization,angnia,target vessel revascularization and target lesion restenosis.CAG was performed after 6 months follow-up to observe the instent restenosis(ISR) and the thrombosis.Results:The analysis of the data shows that LM lesion was ostial-proximal in 12.3%,mid shaft in 15.4%and distal in 72.3%. Procedure success rate was 100%.None of the patient had acute myocardial infarction or coronary artery tear during the PCI.The total number of the stents were 95(Cypher 58,TAXUS 17,Firebird 11,partner 9).Stent diameter were 3.1±0.5mm and stent length were 14.7±6.4mm.Both branches were stented in 35(74.5%) distal lesion patients(Crush technique threeteen cases,Y-stent technique eight cases,T-stent technique six cases, V-stent technique eight cases).The in-hospital survival rate was 100%and in-hospital major adverse cardiac events(MACE) did not occur during hospitalization.CAG follow-up performed in 34(63.0%) patients and showed restenosis in 2 patients(5.9%).At 3-month and 6-month follow-up,there was no MACE effective.Last follow-up was performed in 54 patients,6(11.1%) of them recured angina.Among them 2 patients with CABG,3 patients with repeated PCI,and the other with drugs.The survival rate with non-symptom is 88.9%.Conclusion:ULMCA treated by DES has little MACE events and high survival rate.The clinical outcome of PCI with DES is effective.