Clinical and angiographic outcome of the proximal left anterior descendingcoronary artery angioplasty: Stent vs balloon

Introduction and objectives. The restenosis rate after coronary balloon ang ioplasty of lesions located in the proximal segment of the left anterior de scending coronary artery is high, having been recommended elective stent im plantation in order to improve the outcomes. The aim of this study was to analyze clinical, anatomic and angiographic fa ctors related to the shortterm outcome after angioplasty of severe lesions in the proximal segment of the left anterior descending artery, with and wi thout stent implantation. Material and methods. We study 87 patients with severe estenosis (greater t han or equal to 70%) of the proximal segment of left anterior descending ar tery treated succesfully with angioplasty. In 54 patients (62%) a conventio nal balloon was used (group A) and in 33 (38%) a stent was implanted (group B). Results. Mean age of patients was 61,9 +/- 12 years old, 74% were male and angioplasty was performed because of unstable angina in 72%, At the end of the follow-up (mean 6.3 +/- 1.5 months), 21% of patients in group B had ang ina vs 54% in group A (p = 0.03). Group B patients experienced a lower rest enosis rate (30% vs. 50%; p = 0.07) and less repeat angioplasty procedures (33% vs 21%; p = NS) than group A. These results were mantained independent ly of the vessel diameter (< 3 mm or greater than or equal to 3 mm) or when an optimal result (< 25%) after balloon angioplasty was obtained. Conclusions. In our experience, stenting of lesions located in the proximal segment of the left anterior descending artery appears imply a better shor t-term clinical, angiographic outcome and a lower restenosis rate than lesi ons treated with conventional balloon angioplasty, even despite an optimal result after balloon angioplasty or independently of the vessel diameter. F uture studies will be necessary to confirm these results.