中 Sign In
中 Sign In
Education Center >> Scientific Library >>Stenting Left Main
Review Article
2018 Nov 20. [Epub ahead of print]
JOURNAL：Cardiovasc Revasc Med.
Article Link

Revascularization of left main coronary artery
Baydoun H, Jabbar A, Nakhle A et al.

KEYWORDS
Left main coronary artery ; CABG; PCI; IVUS-guidance; high surgical risk; DES; atherectomy techniques;


Highlights


  • - CABG is still the preferred way to treat patients with unprotected left main disease (UPLMD).

  • - PCI is a reasonable approach mainly in patients with high surgical risk and non-complex anatomy (Syntax score <33).

  • - IVUS-guided PCI is associated with lower risks of all-cause death, cardiac death, TVR and in-stent thrombosis.

  • - FFR is feasible but less validated than IVUS for LM disease and should be used in correlation with IVUS.

  • - DK crush is favored over other techniques for true distal LM bifurcation with lower rates of MI, stent thrombosis and TLR.

Left main coronary artery (LMCA) disease affect 5-7% of patient undergoing coronary angiography and is associated with multivessel CAD in 70% of the cases. Untreated significant LMCA disease is associated with significant mortality and morbidity. CABG is the traditional therapy for revascularization in LMCA disease. PCI is a reasonable alternative mainly in patients with high surgical risk or other specific factors. Drug-eluting stents, improved antiplatelet therapeutic options, atherectomy techniques, IVUS-guidance and improved operator experience have all contributed to the observed improvement in clinical outcomes. Given the large number of variables involved in deciding between PCI and CABG, a heart team should make decisions regarding revascularization of LMCA disease.

http://www.cbsmd.cn Contact us by cbs@cbsmd.cn

Copyright ⓒ CBSMD Nanjing China. All rights reserved.