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Titolo:
Unprotected left main coronary artery stenting - Correlates of midterm survival and impact of patient selection
Autore:
Black, A; Cortina, R; Bossi, I; Choussat, R; Fajadet, J; Marco, J;
Indirizzi:
Clin Pasteur, Unite Cardiol Intervent, F-31076 Toulouse, France Clin Pasteur Toulouse France F-31076 Intervent, F-31076 Toulouse, France Geelong Hosp, Dept Cardiol, Geelong, Vic, Australia Geelong Hosp Geelong Vic Australia Dept Cardiol, Geelong, Vic, Australia
Titolo Testata:
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
fascicolo: 3, volume: 37, anno: 2001,
pagine: 832 - 838
SICI:
0735-1097(20010301)37:3<832:ULMCAS>2.0.ZU;2-M
Fonte:
ISI
Lingua:
ENG
Soggetto:
LONG-TERM FOLLOW; PERCUTANEOUS TREATMENT; SURGICAL TREATMENT; BYPASS SURGERY; DISEASE; ANGIOPLASTY; IMMEDIATE; STENOSIS; OUTCOMES; LESION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
34
Recensione:
Indirizzi per estratti:
Indirizzo: Fajadet, J Clin Pasteur, Unite Cardiol Intervent, 45 Ave Lombez, F-31076 Toulouse, France Clin Pasteur 45 Ave Lombez Toulouse France F-31076 use, France
Citazione:
A. Black et al., "Unprotected left main coronary artery stenting - Correlates of midterm survival and impact of patient selection", J AM COL C, 37(3), 2001, pp. 832-838

Abstract

OBJECTIVES The study served to present the in-hospital and six month clinical outcome and also the long-term survival data of a consecutive series ofpatients undergoing stenting for unprotected left main coronary artery (LMCA) disease. BACKGROUND Revascularization with coronary bypass surgery has been generally recommended for treatment of left main coronary stenosis. Improvements in angioplasty and coronary stent techniques and equipment may result in thewider applicability of a percutaneous approach. METHODS A total of 92 consecutive patients underwent unprotected LMCA stenting between March 1994 and December 1998. For the initial 39 patients (group I) angioplasty was performed only when surgical revascularization was contraindicated. The remaining 53 patients (group II) also included patients in whom surgery was feasible. Patients were followed for 7.3 +/- 5.8 months(median 239 days; range 49 to 1,477 days). RESULTS Compared to group I, group II patients had higher left ventricularejection fraction (60 +/- 12% vs. 51 +/- 16%, p < 0.01), less severe LMCA stenosis (68 +/- 12%, vs. 80 +/- 10%, p < 0.001), lower surgical risk score(13 +/- 7 vs. 20 +/- 7, p ( 0.001), and had angioplasty more often performed via the radial approach (88% vs. 23%, p < 0.001) with smaller guiding catheters (6F: 49% vs. 15%; 8F: 2% vs. 77%, p < 0.001). The procedural success rate was 100%. In-hospital mortality was 4% (4 deaths, 3 cardiac). Duringfollow-up there were six deaths, 13 patients required repeat percutaneous transluminal coronary angioplasty (4 LMCA), and two required coronary artery bypass graft surgery. Estimated survival (+/-SEE) was 89 +/- 6.3% at 500 days and 85 +/- 12%, at 1,000 days post-stenting. Overall mortality was 3.8% in group II and 20.5% in group I (p < 0.02). CONCLUSIONS Coronary stenting can be performed safely in high-risk individuals with acceptable Intermediate-term outcome. It may be feasible to broaden the application of this technique in selected patients needing revascularization for left main coronary disease. (J Am Coil Cardiol 2001;37:832-8) (C) 2001 by the American College of Cardiology.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 05/04/20 alle ore 06:17:59