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Clinical outcome after management of unprotected left main in-stent restenosis after bare metal or drug-eluting stents / 中华医学杂志(英文版)
Chinese Medical Journal ; (24): 794-799, 2010.
Article in English | WPRIM | ID: wpr-242567
ABSTRACT
<p><b>BACKGROUND</b>Implantation of either bare metal stent (BMS) or drug-eluting stent (DES) has been used in every day practice for patients with unprotected left main stenosis (UPLMS). There are still a lack of data regarding the subsequent results of UPLMS in-stent restenosis (ISR). The present study aimed at determining the clinical outcome of UPLMS ISR patients after implantation of either BMS or DES.</p><p><b>METHODS</b>Patients with UPLMS ISR after stenting were included. The primary endpoint was the cumulative major adverse cardiac events (MACE), including cardiac death, myocardial infarction (MI), and target vessel revascularization (TVR).</p><p><b>RESULTS</b>UPLMS ISR rate was 14.8% (n = 73, 15.7% after BMS, 14.5% for DES) after average of (3.89 +/- 2.01) years (range from 1 to 10.5 years) follow-up. Angiographic follow-up between 6 - 8 months was available in 85.3%. Of these, repeat percutaneous coronary intervention (PCI) was used in 62 (84.9%) patients, with medicine only in 9 (12.4%) and coronary artery bypass graft (CABG) in 2 (2.7%). Most repeat PCI patients were with unstable angina (87.0%), and had decreased left ventricular ejection fraction ((42.58 +/- 5.12)%), fewer focal/ostial left circumflex branch (LCX) lesions, in relative to medicine only group. After (31.9 +/- 23.3) months, the MACE, MI, TVR and cardiac death were 31.5%, 1.4%, 24.1% and 8.2%, respectively. Definite and possible stent thrombosis occurred in 1 (1.4%) patient.</p><p><b>CONCLUSIONS</b>Medical therapy for asymptomatic isolated ostial LCX was safe. Repeat PCI for UPLMS ISR was associated with acceptable early and short-term clinical outcome. Further study was needed to elucidate the role of CABG in treating UPLMS ISR.</p>
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Full text: Available Index: WPRIM (Western Pacific) Main subject: Pathology / Therapeutics / Angioplasty, Balloon, Coronary / Stents / Treatment Outcome / Coronary Angiography / Coronary Restenosis / Drug-Eluting Stents Limits: Aged / Aged80 / Female / Humans / Male Language: English Journal: Chinese Medical Journal Year: 2010 Type: Article

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Full text: Available Index: WPRIM (Western Pacific) Main subject: Pathology / Therapeutics / Angioplasty, Balloon, Coronary / Stents / Treatment Outcome / Coronary Angiography / Coronary Restenosis / Drug-Eluting Stents Limits: Aged / Aged80 / Female / Humans / Male Language: English Journal: Chinese Medical Journal Year: 2010 Type: Article