EBC - ON DEMAND
European Bifurcation Club 2010, EBC 2010 – Budapest, Hungary
Left Main session: focusing on techniques and late outcome
LEMAX
Author: Olivier Darremont, MD, Clinique St. Augustin Bordeaux, France
LEMAX PILOT STUDY
- 4 French centers
- Prospective observational study, December 07 to May09
- Efficacy and safety of Xience V everolimus-elutingstent for unprotected de novo LM stenosis
- Primary end point : MACCE at 1 year
- e-CRF
- Angiographic analysis and adjudication of events by independent committee
- Clinical follow-up at 1 month, 1, 2 & 3 years
STRATEGY
- Dual antiplatelet therapy > 12h beforePCI, and for at least 6 months
- MB stenting with provisional side branch stenting strategy
- Final kissing balloon
- Ostial coverage in all cases
CONCLUSION
- Unprotected left main PCI using everolimus eluting stent provided excellent immediat results and very good in-hospital outcomes, even with a very simple treatment strategy in distal location (only 19% of 2 stents implantation).
- At one year follow up, results are promising
- Total death 2.9%, cardiac death 1.1 %
- TLR 2.3 %
- No late stent thrombosis!
- There is an increase of MACCE in patients with high Syntax Score (≥ 33)
- Diabetes is the strongest predictor of MACCE
- Longer follow-up is needed to confirmthese results