A prospective study of elective stenting in unprotected left main coronarydisease

The standard treatment of left main coronary artery (LMCA) disease has been bypass surgery (CABG). Recent reports suggested that stenting of LMCA dise ase might be feasible. From January 1995 to April 1998, we carried out a pr ospective study of elective stenting of unprotected LMCA disease to evaluat e its immediate and long-term results. Of 61 consecutive patients with unpr otected LMCA disease, 6 were excluded. Acute procedural success was 100% fo r the remaining 55 patients, without any complications such as stent thromb osis, myocardial infarction, CABG, or death. During a mean follow-up of 16. 1 +/- 9.6 months, 11 patients (20%) had symptomatic recurrence, between 2 t o 6 months after their procedure. Seven patients underwent CABG, two had re peat intervention, one continued with medical therapy, and one died before planned angiography. There was no late sudden death, Forty-four patients (8 0%) remained asymptomatic. We conclude that elective stenting may be a safe alternative to CABG in unprotected LMCA disease. (C) 1999 Wiley-Liss, Inc.