{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T15:15:41Z","timestamp":1773155741390,"version":"3.50.1"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"17","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2009,5,5]]},"abstract":"<jats:p>\n            <jats:bold>\n              <jats:italic>Background\u2014<\/jats:italic>\n            <\/jats:bold>\n            Cardiac surgery is the reference treatment for patients with left main (LM) disease, although percutaneous coronary intervention with drug-eluting stents is emerging as a possible alternative. The objective of this registry was to evaluate the 2-year outcome of elective percutaneous coronary intervention for unprotected LM disease with paclitaxel-eluting stents.\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Methods and Results\u2014<\/jats:italic>\n            <\/jats:bold>\n            A total of 291 patients were prospectively included from 4 centers. Acute myocardial infarction and cardiogenic shock were the only exclusion criteria. Patients were 69\u00b111 years old, 29% were diabetic, and 25% had 3-vessel disease. For distal LM lesions (78%), the provisional side-branch T-stenting approach was used in 92% of cases and final kissing balloon inflation in 97%. Angiographic success was obtained in 99.7% of cases. At 2-year follow-up, the total cardiac death rate was 5.4% (1 EuroSCORE point was associated with a 15% [95% confidence interval 2.9% to 28.2%,\n            <jats:italic>P<\/jats:italic>\n            =0.013] higher risk of cardiac death), target-lesion revascularization was 8.7%, and incidence of Q-wave or non\u2013Q-wave myocardial infarction was 0.9% and 3.1%, respectively. The combined end point occurred in 15.8% of cases and stroke in 0.7%. The incidence of definite and probable LM stent thrombosis was 0.7%, whereas the incidence of any stent thrombosis was 3.8%, with a higher risk in patients with side-branch stenting in the presence of LM bifurcation lesions (hazard ratio 9.6, 95% confidence interval 1.2 to 77.7,\n            <jats:italic>P<\/jats:italic>\n            =0.035).\n          <\/jats:p>\n          <jats:p>\n            <jats:bold>\n              <jats:italic>Conclusions\u2014<\/jats:italic>\n            <\/jats:bold>\n            Unprotected LM stenting with paclitaxel-eluting stents, with a strategy of provisional side-branch T-stenting for distal lesions, provides excellent acute angiographic results and good mid-term clinical outcomes, with a 15.8% rate of major adverse cardiac events at 2-year follow-up.\n          <\/jats:p>","DOI":"10.1161\/circulationaha.108.804930","type":"journal-article","created":{"date-parts":[[2009,4,21]],"date-time":"2009-04-21T01:46:18Z","timestamp":1240278378000},"page":"2349-2356","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":62,"title":["Unprotected Left Main Stenting in the Real World"],"prefix":"10.1161","volume":"119","author":[{"given":"Beatriz","family":"Vaquerizo","sequence":"first","affiliation":[{"name":"From the Institut Cardiovasculaire Paris Sud (B.V., T.L., Y.L., H.R., F.d.M., M.-C.M.), Institut hospitalier Jacques Cartier, Massy, France; Clinique Saint-Augustin (O.D., J.L.L.), Bordeaux, France; Clinique du Parc Rambot (M.S.), Aix En Provence, France; Institut Cardiovasculaire Paris Sud (P.G., T.U.), Hopital Claude Galien, Quincy, France; and Institute of Social and Preventive Medicine (M.Z.), Bern University, Bern, Switzerland."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thierry","family":"Lefe\u0300vre","sequence":"additional","affiliation":[{"name":"From the Institut Cardiovasculaire Paris Sud (B.V., T.L., Y.L., H.R., F.d.M., M.-C.M.), Institut hospitalier Jacques Cartier, Massy, France; Clinique Saint-Augustin (O.D., J.L.L.), Bordeaux, France; Clinique du Parc Rambot (M.S.), Aix En Provence, France; Institut Cardiovasculaire Paris Sud (P.G., T.U.), Hopital Claude Galien, Quincy, France; and Institute of Social and Preventive Medicine (M.Z.), Bern University, Bern, Switzerland."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivier","family":"Darremont","sequence":"additional","affiliation":[{"name":"From the Institut Cardiovasculaire Paris Sud (B.V., T.L., Y.L., H.R., F.d.M., M.-C.M.), Institut hospitalier Jacques Cartier, Massy, France; Clinique Saint-Augustin (O.D., J.L.L.), Bordeaux, France; Clinique du Parc Rambot (M.S.), Aix En Provence, France; Institut Cardiovasculaire Paris Sud (P.G., T.U.), Hopital Claude Galien, Quincy, France; and Institute of Social and Preventive Medicine (M.Z.), Bern University, Bern, Switzerland."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc","family":"Silvestri","sequence":"additional","affiliation":[{"name":"From the Institut Cardiovasculaire Paris Sud (B.V., T.L., Y.L., H.R., F.d.M., M.-C.M.), Institut hospitalier Jacques Cartier, Massy, France; Clinique Saint-Augustin (O.D., J.L.L.), Bordeaux, France; Clinique du Parc Rambot (M.S.), Aix En Provence, France; Institut Cardiovasculaire Paris Sud (P.G., T.U.), Hopital Claude Galien, Quincy, France; and Institute of Social and Preventive Medicine (M.Z.), Bern University, Bern, Switzerland."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yves","family":"Louvard","sequence":"additional","affiliation":[{"name":"From the Institut Cardiovasculaire Paris Sud (B.V., T.L., Y.L., H.R., F.d.M., M.-C.M.), Institut hospitalier Jacques Cartier, Massy, France; Clinique Saint-Augustin (O.D., J.L.L.), Bordeaux, France; Clinique du Parc Rambot (M.S.), Aix En Provence, France; Institut Cardiovasculaire Paris Sud (P.G., T.U.), Hopital Claude Galien, Quincy, France; and Institute of Social and Preventive Medicine (M.Z.), Bern University, Bern, Switzerland."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jean Louis","family":"Leymarie","sequence":"additional","affiliation":[{"name":"From the Institut Cardiovasculaire Paris Sud (B.V., T.L., Y.L., H.R., F.d.M., M.-C.M.), Institut hospitalier Jacques Cartier, Massy, France; Clinique Saint-Augustin (O.D., J.L.L.), Bordeaux, France; Clinique du Parc Rambot (M.S.), Aix En Provence, France; Institut Cardiovasculaire Paris Sud (P.G., T.U.), Hopital Claude Galien, Quincy, France; and Institute of Social and Preventive Medicine (M.Z.), Bern University, Bern, Switzerland."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe","family":"Garot","sequence":"additional","affiliation":[{"name":"From the Institut Cardiovasculaire Paris Sud (B.V., T.L., Y.L., H.R., F.d.M., M.-C.M.), Institut hospitalier Jacques Cartier, Massy, France; Clinique Saint-Augustin (O.D., J.L.L.), Bordeaux, France; Clinique du Parc Rambot (M.S.), Aix En Provence, France; Institut Cardiovasculaire Paris Sud (P.G., T.U.), Hopital Claude Galien, Quincy, France; and Institute of Social and Preventive Medicine (M.Z.), Bern University, Bern, Switzerland."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen","family":"Routledge","sequence":"additional","affiliation":[{"name":"From the Institut Cardiovasculaire Paris Sud (B.V., T.L., Y.L., H.R., F.d.M., M.-C.M.), Institut hospitalier Jacques Cartier, Massy, France; Clinique Saint-Augustin (O.D., J.L.L.), Bordeaux, France; Clinique du Parc Rambot (M.S.), Aix En Provence, France; Institut Cardiovasculaire Paris Sud (P.G., T.U.), Hopital Claude Galien, Quincy, France; and Institute of Social and Preventive Medicine (M.Z.), Bern University, Bern, Switzerland."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federico","family":"de Marco","sequence":"additional","affiliation":[{"name":"From the Institut Cardiovasculaire Paris Sud (B.V., T.L., Y.L., H.R., F.d.M., M.-C.M.), Institut hospitalier Jacques Cartier, Massy, France; Clinique Saint-Augustin (O.D., J.L.L.), Bordeaux, France; Clinique du Parc Rambot (M.S.), Aix En Provence, France; Institut Cardiovasculaire Paris Sud (P.G., T.U.), Hopital Claude Galien, Quincy, France; and Institute of Social and Preventive Medicine (M.Z.), Bern University, Bern, Switzerland."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thierry","family":"Unterseeh","sequence":"additional","affiliation":[{"name":"From the Institut Cardiovasculaire Paris Sud (B.V., T.L., Y.L., H.R., F.d.M., M.-C.M.), Institut hospitalier Jacques Cartier, Massy, France; Clinique Saint-Augustin (O.D., J.L.L.), Bordeaux, France; Clinique du Parc Rambot (M.S.), Aix En Provence, France; Institut Cardiovasculaire Paris Sud (P.G., T.U.), Hopital Claude Galien, Quincy, France; and Institute of Social and Preventive Medicine (M.Z.), Bern University, Bern, Switzerland."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcel","family":"Zwahlen","sequence":"additional","affiliation":[{"name":"From the Institut Cardiovasculaire Paris Sud (B.V., T.L., Y.L., H.R., F.d.M., M.-C.M.), Institut hospitalier Jacques Cartier, Massy, France; Clinique Saint-Augustin (O.D., J.L.L.), Bordeaux, France; Clinique du Parc Rambot (M.S.), Aix En Provence, France; Institut Cardiovasculaire Paris Sud (P.G., T.U.), Hopital Claude Galien, Quincy, France; and Institute of Social and Preventive Medicine (M.Z.), Bern University, Bern, Switzerland."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie-Claude","family":"Morice","sequence":"additional","affiliation":[{"name":"From the Institut Cardiovasculaire Paris Sud (B.V., T.L., Y.L., H.R., F.d.M., M.-C.M.), Institut hospitalier Jacques Cartier, Massy, France; Clinique Saint-Augustin (O.D., J.L.L.), Bordeaux, France; Clinique du Parc Rambot (M.S.), Aix En Provence, France; Institut Cardiovasculaire Paris Sud (P.G., T.U.), Hopital Claude Galien, Quincy, France; and Institute of Social and Preventive Medicine (M.Z.), Bern University, Bern, Switzerland."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa012843"},{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000155256.88940.f8"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000158486.20865.8b"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.107.692178"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0801441"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.03.020"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1157\/13084649"},{"key":"e_1_3_2_8_2","first-page":"31","volume":"1","year":"2005","unstructured":"Lefevre T, Morice MC, Sengottuvel G, Kokis A, Monchi M, Dumas P, Louvard Y. 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