Emergency percutaneous coronary interventions for unprotected left main stenoses: immediate and long term follow up

Acute occlusion of the unprotected left main coronary artery (LMCA) is fatal in most cases. The life of the patient can be saved by the rapid reperfusion of the occluded LMCA by means of catheter intervention. However, percutaneous coronary interventions (PCI) of LMCA are discouraged by most guidelines. We describe 35 patients who underwent emergency PCI of the unprotected LMCA. Emergency PCI of the unprotected LMCA was performed in 35 cases, representing 0.2% of the 17 683 patients who underwent PCI at our centre between January 1990 and July 2001. Twenty six of the study patients (74.3%) were being treated in the setting of acute myocardial infarction (AMI). In the nine other patients (25.7%) the procedure was performed as an emergency treatment for dissection that occurred during coronary angiography. Patient characteristics and angiographic data are shown in table 1. View this table: Table 1  Characteristics and angiographic data of 35 patients undergoing emergency PCI of the LMCA The magnitude of STT elevation in lead AVR is also shown in table 1. Twenty four patients (68.6%) had ST segment elevation in lead AVR. Patients …