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Current Interventions for the Left Main Bifurcation Wearable Cardioverter-Defibrillator Therapy for the Prevention of Sudden Cardiac Death A Systematic Review and Meta-Analysis Contemporary Management of Cardiogenic Shock: A Scientific Statement From the American Heart Association Transcatheter Aortic-Valve Replacement with a Self-Expanding Valve in Low-Risk Patients A Randomized Trial of a 1-Hour Troponin T Protocol in Suspected Acute Coronary Syndromes: The Rapid Assessment of Possible ACS In the Emergency Department with High Sensitivity Troponin T (RAPID-TnT) Study 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC) Investigating methotrexate toxicity within a randomized double-blinded, placebo-controlled trial: Rationale and design of the Cardiovascular Inflammation Reduction Trial-Adverse Events (CIRT-AE) Study Fourth Universal Definition of Myocardial Infarction (2018) Progression of Device-Detected Subclinical Atrial Fibrillation and the Risk of Heart Failure Astro-CHARM, the First 10-year ASCVD Risk Estimator Incorporating Coronary Calcium

Review ArticleVolume 10, Issue 9, 8 May 2017, Pages 849-865

JOURNAL:JACC Cardiovasc Interv. Article Link

Current Interventions for the Left Main Bifurcation

Rab T, Sheiban I, Louvard Y et al Keywords: bifurcation; left main; stenting techniques

ABSTRACT

Contemporary clinical trials, registries, and meta-analyses, supported by recent results from the EXCEL (Everolimus-Eluting Stents or Bypass Surgery for Left Main Coronary Artery Disease) and NOBLE (Percutaneous Coronary Angioplasty Versus Coronary Artery Bypass Grafting in Treatment of Unprotected Left Main Stenosis) trials, have established percutaneous coronary intervention of left main coronary stenosis as a safe alternative to coronary artery bypass grafting in patients with low and intermediate SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) scores. As left main percutaneous coronary intervention gains acceptance, it is imperative to increase awareness for patient selection, risk scoring, intracoronary imaging, vessel preparation, and choice of stenting techniques that will optimize procedural and patient outcomes.