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• W2080817967 abstract "La cirugía es el tratamiento de elección de la estenosis del tronco. Los stents convencionales no son una alternativa debido a la reestenosis e incidencia de muerte súbita. Los stents liberadores de fármacos, al disminuir la reestenosis, pueden ser una terapia válida. El objetivo del estudio es describir los resultados del stent con liberación de fármacos en pacientes con lesión en tronco no candidatos a tratamiento quirúrgico. Se analizó la evolución de una serie de pacientes consecutivos no candidatos a cirugía a los que se implantó un stent liberador de fármacos entre mayo de 2002 y abril de 2004 por lesión en el tronco. Se analizaron los resultados intrahospitalarios y a largo plazo. Se realizó un seguimiento angiográfico y con ultrasonidos intracoronarios. Se estudió a 42 pacientes, con una edad de 70,1 ± 10,5 años, 25 (59,5%) varones, y 14 (33%) diabéticos; 7 (16,7%) tenían tronco protegido. El motivo de imposibilidad de cirugía fue por malos vasos en 19 (45,2%) casos, cirugía previa en 9 (21,4%), edad en 6 (14,3%), angioplastia primaria en 5 (11,4%) y otras causas en 3 (7,2%) pacientes. Cuatro (9,5%) pacientes fallecieron antes del alta; a 3 de ellos se les practicó una angioplastia primaria, y no hubo necesidad de nueva revascularización. La mediana de seguimiento fue de 288 días (media, 315 ± 241). Otros 4 (9,5%) fallecieron después del alta, en los días 5, 24, 34 y 115. Se repitió la angioplastia en un caso y en otro se practicó un trasplante. Los stents liberadores de fármacos representan una alternativa para los pacientes con lesiones en el tronco que no son candidatos a cirugía. Se deberían hacer estudios aleatorizados con seguimiento a largo plazo para valorar su validez en pacientes elegibles para cirugía. Surgical revascularization is the treatment of choice in patients with left main coronary artery stenosis. Conventional stents are not a valid alternative because of the rate of restenosis and sudden cardiac death. Drug-eluting stents, which reduce the rate of restenosis, may represent an alternative to cardiac surgery. The objective of this study was to describe the results with drug-eluting stents in patients with left main coronary artery stenosis who were poor candidates for surgical revascularization. We prospectively followed a consecutive series of patients who were poor candidates for surgical revascularization and were treated with implantation of a drug-eluting stent in the left main coronary artery between May 2002 and April 2004. In-hospital and long-term results were analyzed. Follow-up included angiographic and intravascular ultrasound (IVUS) studies. Forty-two patients (25 men, 59.5%) with a mean age of 70.1 (10.5) years were studied. Fourteen (33%) had diabetes, and 7 (16.7%) had a protected left main coronary artery. The reasons for ruling out surgery were poor distal vessels in 19 (45.2%), previous surgery in 9 (21.4%), age in 6 (14.3%), primary angioplasty in 5 (11.4%), and other reasons in 3 (7.2%). Four patients (9.5%) died before discharge, three of them after primary angioplasty. No in-hospital revascularization procedures were needed. Median follow-up time was 288 days; mean follow-up time was 315 (241) days. Another four patients died after discharge (9.5%) on days 5, 24, 34 and 115. Angioplasty was repeated in one patient, and another was referred for heart transplantation. Drug-eluting stents represent a valid alternative in patients with left main coronary artery stenosis who are poor candidates for surgical revascularization. Randomized studies with a longer follow-up should be performed to evaluate their benefits in patients eligible for surgery" @default.
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• W2080817967 date "2005-02-01" @default.
• W2080817967 modified "2023-10-18" @default.
• W2080817967 title "Stent liberador de fármacos en lesiones de tronco coronario izquierdo en pacientes no candidatos a revascularización quirúrgica" @default.
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• W2080817967 doi "https://doi.org/10.1157/13071888" @default.
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