Objectives To evaluate the safety and long-term outcomes of unprotected left main coronary artery serious stenosis treated by drug eluting stent (DES).

Methods 43 patients with the unprotected left main coronary artery serious stenosis (stenosis ≥ 90%) were treated by rapamycin-eluting stent in our hospital from May 2007 to October 2011. Among them male was 26 cases and female was 17 cases. The patient age was from 45 to 80 years-old with an average (62.9 ± 8.9) years-old. All patients suffered from acute coronary syndrome. Among them, 2 cases were AMI and 41 cases were unstable angina pectoris and NSTMI, and there were 4 cases with the ostia lesion of left main coronary artery (LM), 3 cases with the lesion in the middle of LM, 11 cases in distal of LM and left anterior descending coronary artery (LAD), and 7 cases with LM lesions involved left circumflex coronary artery (LCX). The lesions of LM involving also LAD and LCX were 18 cases (41.9%) and 36 cases (83.7%) belong to former trigeminal bifurcation lesion. 43 cases suffered from stenosis with 90-95%. All patients were followed-up lasting 14-67 months with a average (37.2 ± 17.2) months. 13 cases were follow-up by coronary angiography (CAG). Their general clinical data, coronary imaging, operation skill, and major adverse cardiovascular event (MACE) were recorded during follow-up. The cardiac death, nonfatal myocardial infarction, target lesion revascularisation were included in the MACE.

Results The rate of MACE in hospitalised was 0%. During the follow-up, the cumulative MACE rate was 7.0%. The cardiac death was two cases (4.7%) represented sudden death. Very late stent thrombosis was one case (2.3%) which happened in 29 months after the stent operation and in distal LAD stent, and who suffered from acute myocardial infarction. 13 cases following up by coronary angiography showed that the very late loss of target vessel lumen was 0–30% with an average 18.46 ± 10.26%.

Conclusions The unprotected left main coronary artery serious stenosis treated by rapamycin-eluting stent implantation was associated with safety and with lower rate of cardiac death, myocardial infarction and stent thrombosis.