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Bare metal stent implantation in large-sized unprotected left main coronary artery stenosis in the drug-eluting stent era

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Abstract

Recently, drug-eluting stent (DES) has been recommended as the first choice in those patients who need stent implantation in unprotected left main coronary artery (ULMCA) stenosis. However, the long-term safety and efficacy of this procedure is still controversial. The objective of this study was to evaluate the safety and efficacy of bare metal stent (BMS) implantation in ULMCA stenting in the DES era. We implanted BMS (mainly 4 mm-diameter) in large-sized ULMCA after December 2004 when DES became available. The results of BMS implantation (n = 19) were compared with those of DES implantation (n = 39). There was no significant difference between the 2 groups regarding age, gender and coronary risk factors. Emergency procedures were more frequently performed in the BMS group than in the DES group (53% vs. 26%, p = 0.08). The initial mortality was 10.5% (n = 2) in the BMS group and 2.6% (n = 1) in the DES group (p = 0.25). There was no stent thrombosis, Q-wave myocardial infarction or emergent bypass surgery in either group during their hospital stay. The restenosis rate was 0% (n = 45) in both groups, and the target vessel revascularization rate was 5.9% in the BMS group (1/17) and 2.6% (1/38) in the DES group (p = 0.53). Therefore, there were no statistically significant differences in outcomes between the two study groups. These results indicate that BMS implantation in a large-sized ULMCA may be a safe and effective treatment even in the DES era.

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Acknowledgments

We are indebted to Mr. Hiroaki Nanba and Mr. Susumu Ohno for their contribution to IVUS data collections.

Conflict of interest statement

Neither I nor any of my co-authors have any relationship with the companies whose products were used in the procedures discussed in this paper.

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Authors and Affiliations

  1. Department of Cardiology, Shiga Medical Center for Adults, 5-4-30, Moriyama, Moriyama, Shiga, Japan

    Kunihiko Kosuga, Masaharu Okada, Shinsaku Takeda, Tatuhiko Hata, Yuzo Takeuchi, Yoshitaka Kawata, Mitsuru Ishii, Kenshi Harita, Soji Nishio & Shigeru Ikeguchi

  2. Kusatsu Heart Center, Kusatsu, Japan

    Eisho Kyo & Takafumi Tsuji

Authors
  1. Kunihiko Kosuga
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  2. Masaharu Okada
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  3. Shinsaku Takeda
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  4. Tatuhiko Hata
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  5. Yuzo Takeuchi
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  6. Yoshitaka Kawata
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  7. Mitsuru Ishii
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  8. Kenshi Harita
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  9. Soji Nishio
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  10. Shigeru Ikeguchi
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  11. Eisho Kyo
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  12. Takafumi Tsuji
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Correspondence to Kunihiko Kosuga.

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Kosuga, K., Okada, M., Takeda, S. et al. Bare metal stent implantation in large-sized unprotected left main coronary artery stenosis in the drug-eluting stent era. Cardiovasc Interv and Ther 25, 65–71 (2010). https://doi.org/10.1007/s12928-009-0011-6

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  • DOI: https://doi.org/10.1007/s12928-009-0011-6

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