Aims Left Main Stem (LMS) percutaneous coronary intervention (PCI) with stents have similar mortality outcomes compared to coronary artery bypass graft surgery, but with a greater risk of repeat revascularisation and potentially fatal stent thrombosis. We report medium term outcomes of drug coated balloon (DCB)-only angioplasty, a novel strategy with no permanent metallic, temporary polymer or scaffold implant.
Methods and Results 24 consecutive patients underwent DCB-only angioplasty for LMS disease from 19/07/2011 to 19/05/2016 at our centre. Clinical outcomes were obtained from the clinic follow up letters and up-to-date mortality data from the Demographic Batch Service Bureau of the Health and Social Care Information Centre. Mean (SD) age of the cohort was 68.0 (11.5) years and 19 (79.2%) were male. 10 (41.7%) patients had previous PCI. 16 (66.7%) patients had unprotected LMS disease and 19 (79.2%) were de novo lesions. 19 (79.2%) were distal bifurcation lesions and mean (SD) syntax score of the unprotected LMS group was 26.4 (12.2). During a mean (SD) follow up of 674.6 (521.7) days there were no cardiac deaths. No target lesion revascularisations, target vessel revascularisations or cerebrovascular accidents reported for a mean (SD) clinic follow up period of 367.6 (331.0) days. 1 (4.2%) patient had a myocardial infarction (MI) unrelated to the previously treated segment. No bail-out stenting, acute vessel closure or treated lesion thrombosis.
Conclusion DCB-only angioplasty to LMS disease appears to be a safe and effective treatment at medium-term follow up.
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