Management of restenosis after drug-eluting stent placement for unprotected left main disease

Abstract

In some institutions a percutaneous approach to unprotected left main (ULM) disease has become a valid alternative to coronary artery bypass graft. Despite the feasibility of the technique and favorable results in terms of low mortality and myocardial infarction rates, restenosis still remains a major issue for interventionalists. In the last few years the use of drug-eluting stents and the availability of new strategies to treat atherosclerosis have only partially succeeded in reducing the phenomenon that still represents an intriguing challenge. A relapse of disease in such a delicate localization, even if causing an acute coronary syndrome in only a third of subjects, may cause severe myocardial ischemia and influence patient prognosis. To date there are many randomized and retrospective studies focusing on the treatment of ‘naive’ ULM but little data regarding the outcome and the optimal management of restenosis in such patients. Our aim is to review the literature in order to summarize the incidence ...