Elective stenting of unprotected left main coronary artery ostial stenoses: short- and mid-term results

Elective stenting as a primary strategy for non-surgical revascularisation was performed in five patients with symptomatic unprotected left main coronary artery ostial stenoses. Their ages ranged from 24 to 57 years (mean: 44.6 +/- 14.4 years). Left ventricular ejection fraction ranged from 35 to 55 percent. All patients underwent successful stenting for left main ostial stenoses using a disarticulated 7 mm Palmaz-Schatz stent. Luminal diameter stenosis reduced from 74 +/- 10.8 to 10 +/- 7.2 percent after the procedure. One patient developed recurrence of angina on the 7th day due to marked recoil of the left main coronary artery with possible thrombosis, requiring immediate coronary artery bypass graft surgery without any sequelae. Remaining four patients were asymptomatic over a mean follow-up of 54 +/- 36 weeks (range: 25-96) and none developed angiographic restenosis at six months. Our preliminary observations therefore suggest that primary stenting is a feasible alternative to bypass graft surgery in patients with unprotected left main coronary artery ostial stenoses.