Should the Left Main Be Covered Entirely with Drug-Eluting Stents in Percutaneous Intervention?
Percutaneous coronary intervention (PCI) with balloon angioplasty or bare-metal stents are not adequate procedures in the treatment of the left main (LM) coronary artery disease because they are associated with an unacceptable restenosis rate, which may present as sudden cardiac death. Although coronary bypass surgery is the preferred method of revascularization,1 PCI with drug-eluting stents (DES) has been performed with promising results.2 There are angiographic and technical details in LM stenting that may be extremely important in the acute and long-term results and have already been studied previously, such as the localization of the lesion within the LM,3 the need for intravascular ultrasound (IVUS)4 and the technique used to approach the bifurcation.5 However, there still remain some questions to be clarified. One of them may be the length of the lesion that should be covered by the stent. We present here the case of a patient with a new lesion in the LM in the segment not cover
Percutaneous coronary intervention (PCI) with balloon angioplasty or bare-metal stents are not adequate procedures in the treatment of the left main (LM) coronary artery disease because they are associated with an unacceptable restenosis rate, which may present as sudden cardiac death. Although coronary bypass surgery is the preferred method of revascularization,1 PCI with drug-eluting stents (DES) has been performed with promising results.2 There are angiographic and technical details in LM stenting that may be extremely important in the acute and long-term results and have already been studied previously, such as the localization of the lesion within the LM,3 the need for intravascular ultrasound (IVUS)4 and the technique used to approach the bifurcation.5 However, there still remain some questions to be clarified. One of them may be the length of the lesion that should be covered by the stent. We present here the case of a patient with a new lesion in the LM in the segment not cover
