A case of unprotected left main coronary stenosis rescued by directional coronary atherectomy as a last resort.

The prognosis of left main coronary stenosis complicating cardiogenic shock is very poor. Unprotected left main coronary stenosis usually preclude percutaneous transluminal coronary angioplasty because of the appearance of elastic recoil and the risk of hemodynamic collapse after acute closure of the artery. An 85-year-old woman with no history of heart disease developed cardiogenic shock. Coronary arteriography showed an unprotected left main coronary stenosis. Due to her advanced age, her family opposed coronary artery bypass surgery. We report here the successful treatment of this case of unprotected left main coronary stenosis by directional coronary atherectomy as a last resort.