Objective: We examined the immediate and long-term outcomes after stenting of all comers for left main coronary artery (LMCA) stenoses.
Background: Left main coronary artery disease is regarded as an absolute contraindication for coronary angioplasty. Recently, several reports on protected or unprotected LMCA stenting, or both, suggested the possibility of percutaneous intervention for this prohibited area.
Material And Method: Eighty-one consecutive patients with LMCA stenoses were treated with stents. The post-stent antithrombotic regimens were aspirin and clopidogrel. The major adverse cardiac events (MACE) including death, Q-wave myocardial infarction, or repeat target lesion revascularization were followed. Patients were followed very closely and all attended office visit at 12 months.
Results: The procedural success rate was 86.4%, with no episodes of acute thrombosis. Follow-up angiography was performed in 30 of 65 eligible patients (46.2%). Angiographic restenosis occurred in eight patients (9.9%). Cumulative death occurred in 16 patients (19.7%). MACE at 30 day and 12-month was 12.3% and 33.3% respectively. From multivariate analysis, dialysis (HR =3.22, p = 0.048), urgent PCI (HR =2.39, p = 0.036), post-procedure TIMI flow < 3 (HR =25.99, p = 0.001) and final kissing balloon inflation (HR = 0.30, p = 0.04) were independent predictors of MACE at 12-month. There was one definite late stent thrombosis (1.2%).
Conclusion: Stenting of LMCA stenosis may be a safe and effective alternative to CABG in carefully selected patients. Further studies in larger patient populations are needed to assess late outcome.
Download full-text PDF |
Source |
|---|
Publication Analysis
Top Keywords
Similar Publications
Dementia Care Research and Psychosocial Factors.
Alzheimers Dement
December 2024
Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA.
Background: Aging associates with decreased functional connectivity between brain regions linked to musical rhythm perception. Producing rhythmic music may result in strengthened functional connectivity of these regions, but more evidence is needed to support intervention design. Currently, few studies directly contrast younger and older adults' rhythmic music performance to understand brain-behavior relationships.
View Article and Find Full Text PDFComparing percutaneous coronary intervention and coronary artery bypass grafting for left main stenosis on the basis of current regional registry evidence.
JTCVS Open
December 2024
Department of Cardiothoracic Surgery, Friedrich-Schiller-University Jena, Jena, Germany.
Objectives: There is an ongoing debate whether percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) is the better choice for treatment of left main (LM) stenosis. We aimed to provide external validation for the recently reviewed guideline recommendations for invasive LM therapy by evaluating the impact of CABG or PCI on long-term survival from local reports of different regions in the world. We performed a systematic review and meta-analysis to address contemporary registry studies comparing PCI and CABG for patients with LM stenosis.
View Article and Find Full Text PDFA novel technique of blindly positioning bronchial blockers for one-lung ventilation: a prospective, randomized, crossover study.
J Cardiothorac Surg
January 2025
Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
Background: Several methods for blindly positioning bronchial blockers (BBs) for one-lung ventilation (OLV) have been proposed. However, these methods do not reliably ensure accurate positioning and proper direction. Here, we developed a clinically applicable two-stage maneuver by modifying a previously reported one-stage maneuver for successful insertion of a BB at the appropriate depth and direction in patients requiring lung isolation where a flexible bronchoscope (FOB) is not applicable.
View Article and Find Full Text PDFThe association between rapid antiretroviral therapy initiation and brain structure and function based on multimodal magnetic resonance imaging in HIV-positive men who have sex with men.
BMC Infect Dis
January 2025
Postgraduate Union Training Base of Jinzhou Medical University, PLA Rocket Force Characteristic Medical Center, Beijing, China.
An increasing number of treatment guidelines recommend rapid initiation of antiretroviral therapy (ART) after the diagnosis of human immunodeficiency virus (HIV) infection. However, data on the association between rapid ART initiation and alterations in brain structure and function remain limited in people with HIV (PWH). A cross-sectional analysis was conducted on HIV-positive men who have sex with men (MSM) undergoing ART.
View Article and Find Full Text PDFStudy protocol for an international registry observational study evaluating clinical outcomes of transcatheter versus standard surgical mitral valve operation for secondary mitral regurgitation: the TEERMISO study.
BMJ Open
January 2025
Department of Cardiac Surgery, Assistance Publique-Hôpitaux de Paris, Creteil, France.
Background: Secondary mitral regurgitation (SMR) is a condition affecting the left ventricle (LV) rather than the mitral valve (MV). If the MV remains structurally unchanged, enlargement of the LV or impairment of the papillary muscles can occur. Several mechanical interventions are available to dictate the resolution of MR.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!