Study of Short and Intermediate Term Clinical Outcomes of Patients with Protected and Unprotected LMCA StentingCorrespondence Address :
Dr. Pooja Vyas,
Assistant Professor, Department of Cardiology, U.N. Mehta Institute of Cardiology and Research Centre,
Ahmedabad-380016, Gujarat, India.
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.
Bail out LMCA stenting, Elective LMCA stenting, LMCA revascularization
Pooja Vyas, Jayesh Prajapati, Sibasis Sahoo, Iva Patel,
Jagjeet Deshmukh, Chirag Patel, et al.. STUDY OF SHORT AND INTERMEDIATE TERM CLINICAL OUTCOMES OF PATIENTS WITH PROTECTED AND UNPROTECTED LMCA STENTING. Journal of Clinical and Diagnostic Research [serial online] 2017 April [cited: 2017 Apr 26 ]; 11:OC29-OC33. Available from
Date of Submission: Jun 03, 2016
Date of Peer Review: Sep 20, 2016
Date of Acceptance: Nov 18, 2016
Date of Publishing: Apr 01, 2017
Financial OR OTHER COMPETING INTERESTS: None.
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