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• W2268351421 abstract "Objectives & background: to compare the outcomes of percutaneous coronary intervention (PCI) using a non-debulking strategy with implantation of either drug-eluting stent (DES) (group Ⅰ; n=49) or hate metal stent (BMS) (Group Ⅱ: n=29) to a selective debulking strategy with directional atherectomy (DCA) before BMS implantation (Group Ⅲ; n=11) for distal unprotected left main coronary artery (ULMCA) stenosis. Methods: This study reviewed the outcomes of 89 consecutive patients who underwent PCI for distal ULMCA stenoses. Restenosis rate, target-lesion revascularization (TLR), and major adverse cardiovascular events (MACE) were analyzed. Results: Group Ⅲ displayed the highest overall restenosis rate (75.0%), primarily involving the ostium of the left circumflex artery, while restenosis was observed at the ULMCA per se in 2.6% of patients in Group Ⅰ. Renal insufficiency (serum creatinine＞1.4mg/dl) was an independent risk factor predicting overall restenosis (OR: 7.704; p=0.047), and implantation of DES associated with lower restenosis rate (OR: 0.189; p=0.002). Cumulative TLR rate at two years was significantly lower in Group Ⅰ than Group Ⅲ (19.3% vs. 49.5%; p=0.011), but Groups Ⅰ and Ⅱ(25.4%) did not differ significantly. Conclusion: This investigation demonstrated that the debulking strategy with selective DCA from left anterior descending artery to ULMCA before BMS implantation did not achieve better clinical outcomes titan a non-debulking strategy with implantation of either BMS or DES. Implantation of DES resulted in significant reduction of restenosis at ULMCA per se. DES had numerically lower TLR anti MACE than those of BMS, which was statistically insignificant due to the small case number." @default.
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• W2268351421 date "2007-12-01" @default.
• W2268351421 modified "2023-09-24" @default.
• W2268351421 title "Percutaneous Coronary Intervention for Distal Unprotected Left Main Coronary Artery Stenoses-The Inadequacy of Selective Debulking Strategy" @default.
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