Key result
Everolimus-eluting stenting for unprotected left main disease resulted in a 15% rate of major adverse cardiac or cerebrovascular events at 12 months.
Why the study?
Does everolimus-eluting stenting prevent major adverse cardiac or cerebrovascular events in patients with de novo significant unprotected left main stenosis?
Observational (n=173)
Yes
Does everolimus-eluting stenting prevent major adverse cardiac or cerebrovascular events in patients with de novo significant unprotected left main stenosis?
Unprotected left main stenting with everolimus-eluting stents is safe and effective at one year, demonstrating low rates of target-lesion revascularization and stent thrombosis.
Supports EES feasibility with provisional stenting in unprotected LM; leaves open need for randomized confirmation before practice change.
AIMS: We sought to assess the efficacy and safety of everolimus-eluting stents for unprotected left main disease. METHODS AND RESULTS: A total of 173 consecutive patients with de novo significant unprotected left main stenosis received an everolimus-eluting stent in four French centres. Among them, 140 (81 %) had involvement of the distal portion of left main, and 129/140 (92%) were treated with provisional side branch T-stenting, with a side branch stenting rate of 20%. Angiographic success was achieved in all cases. At 12 months, the cumulative rate of major adverse cardiac or cerebrovascular events (MACCE) was 26/173 (15%) including death from any cause (N=5, 2.9%), stroke (N=4, 2.3%), Q-wave myocardial infarction (MI) (N=2, 1.2%), non-Q-wave MI (N=6, 3.5%) and any repeat revascularisation (N=16, 9.3%). At one year, the rate of target-lesion revascularisation (TLR) was 5/173 (2.9%), target-vessel revascularisation was 12/173 (7 %) and the rate of definite or probable left main stent thrombosis 1/173 (0.6 %). CONCLUSIONS: Unprotected left main stenting using everolimus-eluting stents and a strategy of provisional side branch T-stenting for distal lesions, is safe and effective in the midterm, with a relatively low rate of events and reintervention at one year.
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Salvatella et al. (2011) conducted an observational in unprotected left main disease (n=173). everolimus-eluting stents was evaluated on major adverse cardiac or cerebrovascular events (MACCE). Everolimus-eluting stenting for unprotected left main disease resulted in a 15% rate of major adverse cardiac or cerebrovascular events at 12 months.
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