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Medicina is published by MDPI from Volume 54 Issue 1 (2018). Articles in this Issue were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence. Articles are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Lithuanian Medical Association, Lithuanian University of Health Sciences, and Vilnius University.
Open AccessArticle

Are Paclitaxel-Eluting Stents Better in Unprotected Left Main Coronary Artery Disease? Three-Year Clinical and Intravascular Imaging Results From a Randomized Study

Latvian Centre of Cardiology, Pauls Stradins Clinical University Hospital, Riga, Latvia
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Medicina 2011, 47(10), 77; https://doi.org/10.3390/medicina47100077
Received: 1 August 2011 / Accepted: 31 October 2011 / Published: 5 November 2011
Background and Objective. Recent publications have demonstrated superior outcomes in unprotected left main patients after paclitaxel-eluting stent (PES) implantation. Long-term data in these patients are limited. The aim of this study was to evaluate if intravascular ultrasound (IVUS)-guided PES implantation is superior to bare metal stent (BMS) implantation in unprotected left main disease after lesion pretreatment with cutting balloon during long-term follow-up.
Material and Methods
. Unprotected left main patients were randomized to BMS (n=50) or PES implantation (n=53). All interventions were IVUS-guided and cutting balloon pretreatment before stenting was performed in all patients. All patients were scheduled for 6-month and 3-year follow-up. Subgroups of patients who underwend IVUS and OCT imaging at 3-year follow-up were analyzed. The primary endpoint was the major adverse cardiac events (MACEs) defined as death, Q-wave myocardial infarction, or target lesion revascularization.
Results
. Baseline characteristics were similar in both the groups with a mean SYNTAX score of 31.4±14.5 in BMS and 32.6±11.7 in PES patients (P=0.718). At 3 years, MACEs occurred in 18 patients (36.0%) in the BMS and 7 patients (13.2%) in the PES group (P=0.011). By IVUS, percent neointimal volume obstruction at 3 years was reduced from 18.1%±8.7% with BMSs to 10.0%±5.4% with PESs (P<0.001). The total number of uncovered stent struts per OCT image and IVUS image was 0.4±0.8 and 1.2±1.5, respectively (P<0.001).
Conclusions
. The current study demonstrated that IVUS-guided PES implantation was superior to BMS implantation after cutting balloon pretreatment in unprotected left main disease at 3 years. If compared with IVUS, OCT was more precise in the assessment of stent endothelization.
Keywords: drug-eluting stents; paclitaxel; left main stenting; long-term; intravascular ultrasound drug-eluting stents; paclitaxel; left main stenting; long-term; intravascular ultrasound
MDPI and ACS Style

Narbute, I.; Jegere, S.; Kumsars, I.; Mintale, I.; Zakke, I.; Bumeistere, K.; Sondore, D.; Grave, A.; Erglis, A. Are Paclitaxel-Eluting Stents Better in Unprotected Left Main Coronary Artery Disease? Three-Year Clinical and Intravascular Imaging Results From a Randomized Study. Medicina 2011, 47, 77.

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