Study of Short and Intermediate Term Clinical Outcomes of Patients with Protected and Unprotected LMCA Stenting
Introduction: Significant unprotected Left Main Coronary Artery (LMCA) disease is detected in 5%-7% of cases undergoing Coronary Angiography (CAG). Present guidelines have revealed the significance of anatomical location in left main artery stenosis and syntax scores for determination of Major A...
Main Authors: | , , , , , , |
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Format: | Article |
Language: | English |
Published: |
JCDR Research and Publications Private Limited
2017-04-01
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Series: | Journal of Clinical and Diagnostic Research |
Subjects: | |
Online Access: | https://jcdr.net/articles/PDF/9716/21821_CE[Ra1]_F(DK)_PF1(SY_PY)_PFA_(SY_PY)_PF2(NE_SS).pdf |
Summary: | Introduction: Significant unprotected Left Main Coronary Artery
(LMCA) disease is detected in 5%-7% of cases undergoing
Coronary Angiography (CAG). Present guidelines have revealed
the significance of anatomical location in left main artery stenosis
and syntax scores for determination of Major Adverse Cardiac
Events (MACE). Debate still persists over the best treatment
regarding outcomes of Coronary Artery Bypass Grafting (CABG)
and LMCA stenting for patients with LMCA disease.
Aim: Aim of the study was to evaluate short and intermediate
term clinical outcomes of Percutaneous Coronary Intervention
(PCI) in LMCA disease in respect to mortality, Cerebrovascular
Accidents (CVA), reinfarction, stent restenosis and need for
repeat target lesion revascularization.
Materials and Methods: From July 2013 to February 2015,
50 patients underwent LMCA stenting. All patients underwent
detailed clinical assessment, detailed 2D echocardiographic
assessment. Syntax score was calculated in all patients. Clinical
in hospital and outpatient follow up was obtained at one, three,
six, nine months and one year.
Results: Mean age was 53.14±9.60 years. On CAG 16 (32%)
patients had ostial LMCA lesion, 8 (16%) had mid LMCA lesion,
distal LMCA was diseased in 6 (12%). In emergency situation,
two bail out LMCA stenting were done for treatment of LMCA
dissection. A total of 42 (84%) patients had low syntax score,
6 (12%) had intermediate and 2 (4%) had high syntax score.
Only LMCA stenting was done in 22 (44%) patients, LMCA to
Left Anterior Descending (LAD) stenting was done in 22 (44%)
and LMCA to Left Circumflex (LCX) stenting was done in 6
(12%) patients. Drug-Eluting Stent (DES) was used in 35 (70%)
cases while Bare-Metal Stent (BMS) was used in 15 (30%). An
8% mortality and 8% target lesion revascularization rate were
observed in our study.
Conclusion: Our study revealed that LMCA stenting is a safe
and feasible alternative mode of revascularization in selected
patients. Patients most suitable for LMCA stenting in our
study were those with isolated ostial/mid LMCA disease, with
protected LMCA disease and those who underwent elective
stenting procedure. |
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ISSN: | 2249-782X 0973-709X |