Stent Choice in Very Large Left Main Lesions in 3 Patients

• Published in: Texas Heart Institute journal Vol. 44; no. 5; pp. 353 - 356
• Main Authors: Lozano, Iñigo, Rondan, Juan, Vegas, José M, Segovia, Eduardo
• Format: Journal Article
• Language: English
• Published: United States Texas Heart® Institute, Houston 01-10-2017
• Subjects: Techniques; Angioplasty, balloon, coronary/methods; drug-eluting stents; percutaneous coronary intervention/trends; coronary disease/therapy; prosthesis design; coronary vessels/anatomy & histology; treatment outcome
• ISSN: 0730-2347; 1526-6702
• DOI: 10.14503/THIJ-17-6190

Interventionalists encounter widely different coronary anatomies during left main coronary artery stenting. Optimal percutaneous coronary intervention in left main disease necessitates stents that achieve adequate apposition and adapt to frequently disparate diameters in the same lesion, without the need for overexpansion. Until recently, stent designs have hampered the treatment of very large lesions in left main arteries. Postdilation of the stents beyond their recommended diameters can cause restenosis, thrombosis, or arterial dissection. We report successful angiographic outcomes after our deployment of different stents in 3 patients, present our rationale for choosing each stent, and discuss considerations that influence the percutaneous treatment of severe left main disease.