27 Clinical outcomes of unprotected left main stem percutaneous coronary intervention in a non-surgical centre

IntroductionThe aim of our study was to evaluate the clinical efficacy and safety of unprotected LMS percutaneous interventions (PCI) in a non-surgical centre.MethodsThe 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.ResultsA 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.ConclusionThis study demonstrates that PCI in LMS lesions performed in a non-surgical centre is both safe and effective.