Jornal de Cirurgia Universal

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Unprotected left main angioplasty in the elderly at a High Flow Catheter Center without an on-site surgical facility: Immediate and intermediate results - The Old Placet Registry

Gagnor Alia

Our objective was to evaluate the clinical feasibility and efficacy of unprotected left primary percutaneous coronary intervention (ULM) in patients over 75 years of age over a period of 6 years and at follow-up. A 2-year follow-up demonstrates that PCI is a viable revascularization strategy even in the absence of local cardiovascular support. However, the future of these high-risk patients remains hampered by reasonable in-hospital mortality. Older patients had a higher mortality at follow-up (10.0 vs 0.8%, P = 0.014), while younger patients had a lower mortality after the acute phase vs. 8.4%, P = 0.15). The incidence of unprotected left coronary artery disease (ULM) during diagnostic coronary angiography varies from 4 to 7% and increases with age. Even recent recommendations consider coronary artery bypass grafting (CABG) as the preferred revascularization strategy for ULM, especially when distal bifurcation is involved and when distal bifurcation is involved. Have disseminated multivessel coronary artery disease. However, the clinical profile and especially age can significantly increase the risk of surgery and thus, despite the encouraging results obtained in elective patients with arterial disease Coronary ULM treated with percutaneous coronary intervention (PCI) and drug-eluting stents (DES) , the outcome in the elderly with ULM (often excluded by randomized trials) is unclear.

Aged patients; Drug-eluting stent; Intervention; Left main coronary artery; Major adverse cardiac events