[Left main coronary artery stenosis and progression of coronary artery atherosclerosis after angioplasty and stenting in patients directed to coronary artery bypass surgery].

Recent investigations demonstrated appearance of left main coronary artery stenosis after PTCA. We performed a retrospective study of specific characteristics of development of coronary lesions after percutaneous coronary interventions (PCI) in patients subjected to coronary artery bypass grafting (CABG) because of angina recurrence after PCI. Data of 150 patients operated because of angina recurrence after PCI were analyzed. The recurrence of angina in 93% of cases was associated with development of significant stenoses in previously intact segments of coronary arteries, but not with restenosis or occlusion of the stented segment. The recurrence of symptoms occurred in 1 year after coronary stenting in 54% of patients. In 19 patients rapid development of a novel left main coronary artery stenosis was observed. Some characteristics of this group (the use of Back-up, XB, AL-catheters, repetitive PCI, manipulations in more than 2 coronary segments, stenting of bifurcations with 2 stents, use of kissing-balloons, small diameter of left coronary artery, and concomitant diabetes) significantly differed from those of the main group. In all patients CABG was successful.