Complications in the immediate and long-term periods of observation after percutaneous coronary interventions on the «unprotected» left main coronary artery

Abstract

Aim. To examine the complications developing immediately or in the long-term period of observation after PCI on the «unprotected» LMCA. Methods. The study included 124 patients with high surgical risk for whom was carried out stenting on the «unprotected» LMCA in the period from August 2002 to November 2004. The cause of death, myocardial infarction and repeated revascularization of vessel were final points of the research. The immediate success of the intervention has reached a score of 96,7%. The average observation period of patients in the study amounted to 38,1 ± 1,8 months. Results. The death depending on cardiac causes was 6,5% of patients, of whom 3 patients have died suddenly. At the same time noncardiac mortality was registered in 4 patients, which occupy in 3,2% of the applicants. A complication in the form of a peripheral pseudoaneurysm of femoral artery, which was subjected to compression therapy under ultrasound has developed in one of the patients. Restenosis in a stenting segment was identified in 20,2% (25 patients) cases. Repeated PCI were carried out in 18 cases, and in 7 - coronary artery bypass grafting. The survival rate of patients by 1, 2 and 3 years has made respectively score of 95,2%, 91,9% and 90,3%. Conclusions. Despite of the high success of direct intervention at PCI on the «unprotected» LMCA using standard metal stents and the relatively low rate of restenosis, PCI at a given location should be perform very carefully. We believe that PCI on «unprotected» LMCA is possible only in patients with high risk of surgical intervention, which are poor candidates for coronary artery bypass surgery.