Effect And Safety Of Intravascular Ultrasound-Guided Percutaneous Coronary Intervention In Patients With Unprotected Left Main Coronary Artery Disease

Objective\r\nTo retrospectively analyze the effect of angiography versus intravascular ultrasound (IVUS)-guided drug-eluting stent implantation for one year in patients with unprotected left main coronary artery (UMLCA) disease.\r\n\r\n\r\nMethods\r\nFrom Jan. 2012 to Jan. 2014, a total of 90 patients with left main coronary artery disease undergoing coronary angiography in our hospital were assigned to IVUS-guided group (n=40, patients received intravascular ultrasound-guided percutaneous coronary intervention after angiography) and control group (n=50, patients treated with drug-eluting stent implantation after angiography). The major adverse cardiac cerebral events (MACE) including recurrence of angina, target vessel revascularization, myocardial infarction, stent thrombosis and cardiovascular death were compared between the two groups at 1 year after intervention.\r\n\r\n\r\nResults\r\nA total of 134 stents were implanted in 90 patients with UMLCA disease among the 2 groups, the instant success rate was 100%, and there was no acute myocardial infarction or other severe complications occurred during percutaneous coronary intervention (PCI). Stents length was 14 mm in the two groups. Post-dilation was more frequently performed in the IVUS-guided group than in control group 〔52.5% (21/40) vs. 28.0% (14/50), P\u003c0.05〕. The minimum lumen area was larger 〔(9.7±1.7) vs. (8.4±1.2), t=3.24, P\u003c0.05〕, and the re-stenosis rate was lower in IVUS-guided group 〔(6.3±2.1) vs. (19.2±5.8), t=0.00, P\u003c0.01〕 than in control group one year after stent implantation. The incidence of MACE was 15% (6/40) in IVUS-guided group and 24% (12/50) in control group during 12 months of follow-up (χ2=42.76, P\u003c0.01).\r\n\r\n\r\nConclusions\r\nPatients with ULMCA disease, who may occur MACE after operation, should take the IVUS-guided percutaneous coronary intervention, in order to decrease the risk of MACE including the under-expansion stent, stent thrombosis, myocardial infarction recurrence, cardiovascular death, which has an important significance on improving the prognosis.\r\n\r\n\r\nKey words: \r\nCoronary artery disease; Ultraso nography intravascular; Angioplasty, transluminal, Percutane ous coronary