Intravascular ultrasound predictors of target lesion revascularization after stenting of protected left main coronary artery stenoses

We evaluated the predictors of late clinical outcomes after stenting of pro tected left main coronary artery (LMCA) stenoses. Intravascular ultrasound (IVUS) guided stenting of protected LMCA stenoses was performed in 87 conse cutive patients between January 1994 and December 1996. Results were evalua ted using conventional (clinical, angiographic, and IVUS) methodology. Late (12 month) clinical follow-up information was obtained in all patients. In itial procedural success was achieved in 86 patients (99%. There was 1 in-h ospital death tin the 1 patient with a procedural Failure). There were no o ther in-hospital complications, including Q-wave myocardial infarction, eme rgency bypass surgery, or repeat coronary angioplasty. The overall target l esion revascularization (TLR) rate was 13%. Using multivariate logistic reg ression analysis, the only independent predictor of TLR was the postinterve ntion lumen area by IVUS. A final lumen area greater than or equal to 7.0 m m(2) was obtained in 74 patients (86%); the TLR rate for these patients was 7%. This was compared with patients with a final lumen area <7.0 mm(2) in whom the TLR rate was 50% (p = 0.0011). Stenting of protected LMCA stenoses is safe and effective with acceptable long-term clinical outcomes. The mos t important factor determining long-term success was the postintervention l umen area by IVUS. (C) 1999 by Excerpta Medica, Inc.