Left main (LM) coronary artery disease is associated with high morbidity and mortality owing to the large myocardial territory at risk for ischemia. Evidence from randomized controlled trials supports that percutaneous coronary intervention (PCI) with drug-eluting stents (DES) for LM disease is an acceptable treatment strategy compared with coronary artery bypass graft surgery in patients with low or intermediate anatomic complexity. However in-stent restenosis (ISR) after DES in LM disease is still occurring with an incidence of 9,7%. Studies comparing the percutaneous coronary intervention with coronary artery bypass grafting (CABG) in the treatment of in-stent restenosis in unprotected left main have been scarce. While surgical revascularization is considered to be the standard treatment for this kind of stent failure, owing to a high risk of perioperative morbidity and mortality, the restoration of flow with PCI may be a reliable alternative. Additionally, it is not clear whether re-PCI is safe in these patients. Therefore, the purpose of the present study was to compare long-term outcomes following PCI or CABG for UPLM-ISR disease.
Study Type
OBSERVATIONAL
Enrollment
305
PCI vs. CABG
Fabrizio D'Ascenzo
Turin, Italy
Department of Invasive Cardiology, Medical University of Bialystok, The Medical University of Bialystok Clinical Hospital
Bialystok, Poland
First Department of Cardiology, Medical University of Gdansk, Gdansk, Poland
Gdansk, Poland
Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
Katowice, Poland
Jacek Legutko
Krakow, Poland
Second Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland
Krakow, Poland
Miedziowe Centrum Zdrowia S.A.
Lubin, Poland
Marek Grygier
Poznan, Poland
Department of Invasive Cardiology, Centre of Postgraduate Medical Education, Central Clinical Hospital of the Ministry of Interior and Administration
Warsaw, Poland
Centre for Heart Disease, University Hospital Wroclaw Department of Heart Disease, Wroclaw Medical University
Wroclaw, Poland
...and 1 more locations
MACCE
Time frame: 4 years
cardiac death
Time frame: 4 years
myocardial infarction
Time frame: 4 years
target vessel revascularization
Time frame: 4 years
stroke
Time frame: 4 years
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