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. 2018 Apr 2:29:188.
doi: 10.11604/pamj.2018.29.188.9640. eCollection 2018.

[Angioplasty of the unprotected left main trunk: short and medium term outcomes]

[Article in French]
Yibar Kambiré  1
Affiliations

[Angioplasty of the unprotected left main trunk: short and medium term outcomes]

[Article in French]
Yibar Kambiré. Pan Afr Med J. .

Abstract
in English, French

Introduction: This study aimed to determine short and medium term outcomes in patients with unprotected left main coronary disease treated by percutaneous intervention.

Methods: We conducted a retrospective study of all patients with unprotected left main coronary artery disease treated by percutaneous intervention between January 2004 and June 2009. Clinical and angiographic data were collected from their medical records and supplemented by a telephone interview with the patients or their doctors.

Results: Forty eight patients with an average age of 68.50 ± 14.06 years were included in the study. Acute coronary syndromes were the primary reason for admission (75%). Patients had distal left main lesions (77.1%) and pluritroncular lesions (64.6%). Bare-metal stents were implanted in 73% of patients. After a mean follow-up of 22 months, the rate of major cardiovascular events was 35.4% (20.8% of restenosis and 14.6% of revascularizations). Hospital mortality rate was 4.2%. Predictive factors of major cardiovascular events included an EuroSCORE ≥ 10 and a history of cardiovascular disease.

Conclusion: Angioplasty of the left main trunk is an alternative approach to emergency situations or when surgery is not indicated. Patients' outcome is dependent on their overall risks factors before angioplasty.

Introduction: Notre but était de déterminer le devenir des patients traités par angioplastie du tronc commun non protégé de l'artère coronaire gauche.

Méthodes: Une étude rétrospective a porté sur tous les patients traités par angioplastie du tronc commun non protégé de la coronaire gauche entre janvier 2004 et juin 2009. Les données cliniques et angiographiques ont été recueillies sur les dossiers médicaux, complétées par un entretien téléphonique avec le patient ou ses médecins.

Résultats: Quarante-huit patients d'âge moyen de 68,50±14,06 ans ont été inclus. Les syndromes coronariens aigus étaient le principal motif d'admission (75%). Les lésions du tronc étaient distales (77,1%) et pluritronculaires (64,6%). Un stent nu a été implanté chez 73% des patients. Après un suivi moyen de 22 mois, le taux d'événements cardiovasculaires majeurs a été de 31,3% dont 20,8% de resténose et 14,6% de revascularisation. Le taux de décès hospitalier a été de 4,2%. Les facteurs prédictifs d'événements cardiovasculaires majeurs ont été un EuroSCORE ≥ 10 et les antécédents cardiovasculaires.

Conclusion: L'angioplastie du tronc commun est une alternative dans les situations d'urgence ou en cas de contre-indication de la chirurgie. Le risque évolutif des patients est lié à leur risque global avant angioplastie.

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Conflict of interest statement

Les auteurs ne déclarent aucun conflit d'intérêts.

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