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Stenting Left Main

Abstract

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Design and rationale for the treatment effects of provisional side branch stenting and DK crush stenting techniques in patients with unprotected distal left main coronary artery bifurcation lesions (DKCRUSH V) Trial Double Kissing Crush Versus Provisional Stenting for Left Main Distal Bifurcation Lesions: DKCRUSH-V Randomized Trial 2-year outcomes with the Absorb bioresorbable scaffold for treatment of coronary artery disease: a systematic review and meta-analysis of seven randomised trials with an individual patient data substudy A randomized clinical study comparing double kissing crush with provisional stenting for treatment of coronary bifurcation lesions: results from the DKCRUSH-II (Double Kissing Crush versus Provisional Stenting Technique for Treatment of Coronary Bifurcation Lesions) trial Clinical Outcome After DK Crush Versus Culotte Stenting of Distal Left Main Bifurcation Lesions: The 3-Year Follow-Up Results of the DKCRUSH-III Study Stent fracture is associated with a higher mortality in patients with type-2 diabetes treated by implantation of a second-generation drug-eluting stent Revascularization of left main coronary artery Everolimus-Eluting Stents or Bypass Surgery for Left Main Coronary Artery Disease

Review Article2015 Mar;40(3):93-126.

JOURNAL:Curr Probl Cardiol. Article Link

Left main coronary artery disease: importance, diagnosis, assessment, and management

Ragosta M. Keywords: Left main coronary disease; Diagnosis; Assessment; Management

ABSTRACT


Left main coronary disease is seen in 4%-6% of patients undergoing coronary angiography for an ischemic evaluation and is a potentially fatal condition if not promptly identified and treated. Recent studies have increased our understanding of the complexity of left main coronary artery disease. This lesion subset offers numerous challenges in diagnosis and management. Fractional flow reserve and intravascular ultrasound are important adjuncts to angiography to determine the significance of ambiguous lesions of the left main coronary artery. Surgery is associated with much better outcomes than medical therapy and is considered by many to be the standard of care in patients who are surgical candidates. Recent studies comparing surgery with percutaneous coronary intervention (PCI) have defined subgroups with lesser extent of disease burden that may do just as well with PCI. Challenges remain in the management of bifurcation disease, and the interventional community anxiously awaits the results of the large-scale randomized trials comparing PCI with surgery.