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Stenting Left Main

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Long-Term Outcomes of Different Two-Stent Techniques With Second-Generation Drug-Eluting Stents for Unprotected Left Main Bifurcation Disease: Insights From the FAILS-2 Study Differential prognostic impact of treatment strategy among patients with left main versus non-left main bifurcation lesions undergoing percutaneous coronary intervention: results from the COBIS (Coronary Bifurcation Stenting) Registry II Complex PCI procedures: challenges for the interventional cardiologist EXCELling in Left Main Intervention Long-term outcomes following mini-crush versus culotte stenting for the treatment of unprotected left main disease: insights from the Milan and New-Tokyo (MITO) registry Operator Experience and Outcomes After Left Main Percutaneous Coronary Intervention Long-term safety and effectiveness of unprotected left main coronary stenting with drug-eluting stents compared with bare-metal stents Left Main Revascularization in 2017: Coronary Artery Bypass Grafting or Percutaneous Coronary Intervention? Mortality after coronary artery bypass grafting versus percutaneous coronary intervention with stenting for coronary artery disease: a pooled analysis of individual patient data Clinical and angiographic outcomes of patients treated with everolimus-eluting stents or first-generation Paclitaxel-eluting stents for unprotected left main disease
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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.

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