Two-Year Outcomes of the
Sirolimus-Eluting Stent According to
Unprotected Left Main Lesion
- Ung Kim; Jong-Seon Park; Sang-Hoon Seol; Tae-Hyun Yang; Sung-Man Kim; Dae-Kyung Kim; Doo-Il Kim; Dong-Soo Kim; Won-Jae Lee; Sang-Hee Lee; Geu-Ru Hong; Dong-Gu Shin; Young-Jo Kim; Bong-Sup Shim; Yoon-Kyung Cho; Hyung-Seop Kim; Chang-Wook Nam; Seung-Ho Hur; Kwon-Bae Kim; Yoon-Nyun Kim
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- Background: The data of long-term outcomes of sirolimus-eluting stent (SES) according to lesion location of
unprotected left main coronary artery (LMCA) is scarce.
Hypothesis: The purpose of this study was to evaluate the long-term outcomes after implantation of the SES
Methods: A total of 84 patients (51 males) who had undergone SES implantation for the treatment of native
LMCA stenosis were enrolled. The patients were divided into 2 groups based on angiographic lesion location:
those with signiﬁcant stenosis in the ostium and/or body (group 1; n = 39) and those involving bifurcation
(group 2; n = 45).
Results: All of the group 1 patients were treated with simple lesion coverage while different stenting techniques
were used in group 2 (cross-over: 44.8%, T: 6.7%, kissing: 37.8%, and crush techniques: 11.1%). The 8-month
quantitative angiographic ﬁndings and in-hospital and 2 year rates of major adverse cardiac events (MACE)
were compared between the 2 groups. Although angiographic success and in-hospital MACE rates were similar
in both groups with 1 cardiac death due to acute stent thrombosis in group 2, at 2-year follow-up, the MACE
rate was signiﬁcantly higher in group 2 than in group 1 at 2 years (22.2% vs 2.6%, respectively, P = 0.008).
Coronary angiography revealed a signiﬁcantly higher binary restenosis rate in group 2 compared with group 1
(20% vs 0%, respectively, P = 0.003).
Conclusions: Interventional treatment using SES in left main lesions showed favorable short-term and long-
term outcomes in selected patients with lesion location being an important determinant of clinical and
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