The EBC MAIN LM study randomized 467 patients with severe left main coronary artery (LCA) lesions to receive provisional stenting or a two-sent strategy (Resolute or Onix stent). The two-stent strategy was decided by the operator (culotte, DK-minicrush, T/TAP).

The crossover rate from those randomized to provisional stenting was 22%.

After a 3-year follow-up, the composite of death, acute myocardial infarction (AMI), and treated lesion revascularization (TLR) was similar (23% vs. 29%; p = 0.13).

Mortality and AMI rates were similar (10% vs. 13%; p = 0.27, and 12% vs.11%; p = 0.75). TLR rates were lower in patients who received provisional stenting (8% vs. 14%; p = 0.02), and most reinterventions were in the circumflex artery ostium.

Dr. Carlos Fava.
Member of the editorial board of SOLACI.org.

Reference: “EBC MAIN in the LM”, presentado por el Dr. David Hildick-Smith en el Congreso EuroPCR 2023, realizado en París, Francia.