[Unprotected left main coronary artery stenting: immediate and medium-term outcomes of 24 procedures]

We have examined the immediate and long-term patient outcomes following angioplasty of unprotected left main coronary artery stenoses.

Coronary disease of the unprotected left main artery is considered as an absolute contraindication for percutaneous intervention. Recently, several studies have reported good results with unprotected left main coronary artery stenting when surgical revascularization was contraindicated.

From October 2004 to June 2006, 24 patients with a contraindication to surgery and with unprotected left main coronary artery stenoses received stents. Patients were surveyed at one, six and 12 months with telephone interviews.

The procedure's success rate was 100%. The percentage of stenosis and minimum lumen diameter (MLD) were respectively 63.4% (+/-15.4) and 1.1mm (+/-0.5) before procedure; 13.8% (+/-10.2) and 3.2mm (+/-0.5) after angioplasty. The size of stents averaged 3.79 mm (+/-0.46) with an average 1.04 stents per patient. During follow up, two deaths occurred (8.3%). No intrastent restenosis was found.

Stenting of unprotected left main coronary artery stenoses may be a safe and effective alternative to coronary artery bypass especially when surgical revascularization is contraindicated. However, further studies with larger patient populations are needed to assess the late outcome and to clarify the relevance of percutaneous intervention compared to surgery.