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27 Clinical outcomes of unprotected left main stem percutaneous coronary intervention in a non-surgical centre
  1. Usha Rao,
  2. Simon Eccleshall,
  3. T Sarev,
  4. L Hughes,
  5. A Ryding,
  6. T Wistow,
  7. Timothy Gilbert
  1. University Hospital of Norfolk and Norwich

Abstract

Introduction The aim of our study was to evaluate the clinical efficacy and safety of unprotected LMS percutaneous interventions (PCI) in a non-surgical centre.

Methods The data on LMS PCI cases performed over 41 months was collected from local database and discharge summaries. Major adverse cardiovascular events (MACE) were also recorded at 6 and 12 months.

Results A total of 147 patients with multiple risk factors had unprotected LMS PCI performed. Demographics were: 73% males with an average age of 70 years. 48% were elective procedures, 31% NSTEMI and 15%PPCI. Bail out stenting was required in 1%. Over 70% of procedures were performed transradially. The average EURO score was 2.89%. The anatomical distribution was: 47% distal LMS, ostial 23% and 22% mid-LMS. Of the lesions 51% involved only the LMS. Additional imaging was used in 41% of PCIs. The mean Syntax score was 34.4. 74% patients had drug eluting stents, followed by bare metal stents (8%), drug eluting balloons (8%) and combo stents. 5% of patients were in cardiogenic shock and 6% had Intra-aortic balloon pump inserted. Procedural success was reported in 96.6% of cases. In-hospital MACE was 3.4%. The MACE rates for 6 months and 12 months were 10.2% and 13.6% respectively. There were 4 in-hospital deaths recorded (2.7%). The study revealed a procedural success of over 95%. The in-hospital MACE was 3.4% and the 12 month MACE rate was comparable to the reported data.

Conclusion This study demonstrates that PCI in LMS lesions performed in a non-surgical centre is both safe and effective.

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