A Randomized Comparison of Drug-Eluting and Bare-Metal Stents in Left Main Lesions

In a small trial, DES outperformed BMS in LMCA lesions, but how it compares with bypass surgery remains to be seen.

Observational studies have shown a reduced rate of restenosis with drug-eluting stents (DES), compared with bare-metal stents (BMS), in unprotected left main coronary artery (LMCA) lesions (Journal Watch Cardiology Apr 8 2005). In a new study, investigators in Australia randomized 103 patients with LMCA disease to treatment with either a BMS or a paclitaxel-eluting stent (PES). All lesions were predilated with a cutting balloon, and stent placement was optimized with intravascular ultrasound (IVUS).

The mean age of treated patients was 62 years, and most had stable symptoms and preserved LV function. Although about 70% of participants had lesions involving the distal bifurcation, only two patients received bifurcation stents. The in-hospital…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI