Arq. Bras. Cardiol. 2021; 116(6): 1101-1108
Percutaneous Coronary Intervention in Unprotected Left Main Coronary Artery Lesions
Douglas dos Santos Grion, Debora Carvalho Grion, Igor Veiga Silverio, Leonardo Shingu de Oliveira, Isabela Faria Larini, Anna Victória Martins, Juliana Moreira, Marianne Machado, Lissa Shizue Tateiwa Niekawa, Adriana dos Santos Grion, Cintia Magalhães Carvalho Grion
This Original Article is referred by the Short Editorial "Left Main Coronary Artery Percutaneous Intervention. Why are Real-World Data so Important?".
Abstract
Background
The advent of drug-eluting stents allowed the percutaneous coronary intervention to present safe results in lesions in the left main coronary artery.
Objectives
To analyze the results of the percutaneous treatment of unprotected left main coronary artery lesion with the use of intravascular ultrasound.
Methods
Study of consecutive case series carried out from January 2010 to December 2018. Clinical data were collected from patients as well as prognostic scores and data on coronary lesion. Low-grade residual lesion (less than 50%) on angiography and minimum luminal area greater than 6 mm2on intravascular ultrasound were considered successful. The adopted significance level was 5%.
Results
107 cases were analyzed. The multivessel lesion was predominant, with most (39.25%) of the lesions being found in three vessels in addition to the left main coronary artery. The SYNTAX score had a mean of 46.80 (SD: 22.95), and 70 (65.42%) patients had a SYNTAX score above 32 points. Angiographic success of percutaneous intervention was considered in 106 (99.06%) patients. The overall rate of major cardiac and cerebrovascular events in the hospital outcome was 6.54%, being similar in patients with SYNTAX score ≤ 32 (8.10%) and ≥ 33 (5.71%; p = 0.68).
Conclusions
Percutaneous intervention in cases of unprotected left main coronary artery lesion was safely performed and presented excellent results. Considerable angiographic success of treatment guided by intravascular ultrasound was achieved. The rate of major cardiac and cerebrovascular events was similar between patients at low and high risks.
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