Randomized Study of Left-Main Stenting

In a small trial, stents were as effective as surgery, but more and longer-term data are needed to confirm the results.

Preliminary and observational data have suggested that percutaneous coronary intervention with stenting is safe and effective in patients with unprotected left-main (LM) coronary artery stenosis. In this randomized study, investigators compared outcomes in 105 such patients in Poland who were assigned to stenting or to coronary artery bypass grafting. All patients were considered suitable for both procedures. Drug-eluting stents were used in the 35% of patients with a reference LM diameter <3.8 mm, and 56% of patients had distal LM disease requiring a provisional PCI approach to the left circumflex artery.

Mean follow-up was 28 months. Improvement in LV ejection fraction at 12 months, the primary endpoint, was greater with PCI (3.3%) than wi…

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