[Stent in protected and non-protected left main coronary artery: results and short-term follow-up]

We examined the immediate and short-term outcomes after stenting protected and unprotected left main coronary artery (LMCA) stenoses, in patients with normal ventricular function. Left main coronary artery disease is regarded as an absolute contraindication for coronary angioplasty, because it has been associated with high procedural morbidity and poor mid-term results. Between february 1995 and february 1999, 596 procedures were performed in 468 patients. Ten patients who had disease involving the left main coronary artery were included. They were not candidates for coronary surgery. The post-stent antithrombotic regimens were aspirin and ticlopidine. The procedural success rate was 100% without episodes of subacute thrombosis. Three to six months follow-up angiography was performed in all, restenosis occurred only in two patients, there were two repeat PTCA (20%) and there were no deaths.

Stenting of unprotected and protected left main coronary artery stenoses may be a safe and effective alternative to surgery in carefully selected patients with normal left ventricular function. The results of our study suggests that when patients have prohibitive surgical risks, elective LMCA angioplasty and/or stenting maybe undertaken with a high procedural success rate as an effective alternative to CABG in carefully selected patients. Further studies in larger patient populations are needed to assess late outcome.