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BACKGROUND & AIM

Incidence And Management Of Restenosis After Treatment Of Unprotected Left Main Disease With Drug-Eluting Stents: 70 Restenotic Cases From A Cohort Of 718 Patients – Failure In Left Main Study (FAILS).

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BACKGROUND & AIM

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  1. Incidence And Management Of Restenosis After Treatment Of Unprotected Left Main Disease With Drug-Eluting Stents: 70 Restenotic Cases From A Cohort Of 718 Patients – Failure In Left Main Study (FAILS) Giuseppe BIONDI-ZOCCAI,a* Dario SILLANO,aAlaideCHIEFFO,b Antonio COLOMBO,b Sabine VECCHIO,c Massimo MARGHERI,c Julian P. GUNN,dTusharRAINA,d Francesco LIISTRO,e Leonardo BOLOGNESE,e Michael S. LEE,f Jonathan TOBIS,f Claudio MORETTI,a Imad SHEIBAN,a - aDivision of Cardiology, University of Turin, Italy; bSt. Raffaele Hospital and Centro Cuore Columbus, Milan, Italy; cDivision of Cardiology, Ravenna Hospital, Ravenna, Italy; dDivision of Cardiology, University of Sheffield, UK; eDivision of Cardiology, San Donato Hospital, Arezzo, Italy; fDivision of Cardiology, UCLA Medical Center, Los Angeles, CA, USA

  2. BACKGROUND & AIM • The promising role of drug-eluting stents (DES) for percutaneous revascularization of unprotected left main (ULM) has been reported in several settings, including the randomized SYNTAX trial. • However no detailed data are available on subsequent restenosis. • We thus aimed to appraise the incidence and management of restenosis following DES implantation for ULM disease.

  3. METHODS • From the total sample of patients with ULM treated with DES, we identified those presenting with angiographic ULM restenosis. • The primary end-point was the long-term rate of major adverse cardiac events (MACE), ie death, myocardial infarction (MI) or target lesion revascularization (TLR). We also adjudicated stent thrombosis according to the Academic Research Consortium.

  4. PARTICIPATING CENTERS Milan Sheffield Los Angeles Firenze Turin Arezzo

  5. STUDY FLOWCHART *5.1% (2.5% dying suddenly) *

  6. BASELINE FEATURES

  7. 1ST PROCEDURE ON ULM

  8. 1ST PROCEDURE ON ULM

  9. 2ND PROCEDURE ON ULM

  10. CLINICAL OUTCOMES All p>0.05 % Cumulative events after >35 months In-hospital

  11. CLINICAL OUTCOMES

  12. CONCLUSIONS • Significant ULM DES restenosis is characterized by a stable clinical condition in most patients, even if a subset of them can present with an acute coronary syndrome. • After more than 24 months of clinical follow-up from the diagnosis of restenosis, MACE rates appear quite favorable in both the interventional and surgical therapy groups.

  13. Manythanks for further slides on thesetopics, please visit the www.metcardio.org website

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