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Stenting Left Main

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Surgical ineligibility and mortality among patients with unprotected left main or multivessel coronary artery disease undergoing percutaneous coronary intervention Randomized Trial of Stents Versus Bypass Surgery for Left Main Coronary Artery Disease: 5-Year Outcomes of the PRECOMBAT 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 Patient selection and percutaneous technique of unprotected left main revascularization Comparison of Outcomes of Percutaneous Coronary Intervention on Native Coronary Arteries Versus on Saphenous Venous Aorta Coronary Conduits in Patients With Low Left Ventricular Ejection Fraction and Impella Device Implantation Achieved or Attempted (from the PROTECT II Randomized Trial and the cVAD Registry) Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Patients With Left Main and Multivessel Coronary Artery Disease: Do We Have the Evidence? Two-year outcomes following unprotected left main stenting with first vs new-generation drug-eluting stents: the FINE registry. EuroIntervention. Management of left main disease: an update Stroke Rates Following Surgical Versus Percutaneous Coronary Revascularization Incidence and Management of Restenosis After Treatment of Unprotected Left Main Disease With Second-Generation Drug-Eluting Stents (from Failure in Left Main Study With 2nd Generation Stents-Cardiogroup III Study)
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Expert Opinion2015;11 Suppl V:V106-10.

JOURNAL：EuroIntervention. Article Link

Differences between the left main and other bifurcations

Lefèvre T, Girasis C, Lassen JF. Keywords: left main anatomy; risks; stenting strategy

ABSTRACT

The left main is the largest bifurcation of the coronary tree and is, therefore, easier to access. Nevertheless, the risks of untoward consequences associated with the loss of the side branch are much higher. Although the usual technical strategies implemented in coronary bifurcations can generally be applied to left main lesions, several inherent characteristics (the ostial position of the main branch, the size of the side branch, the amount of calcification, the angle which is often in a T shape, the use of stents of variable suitability, the crucial role of POT) need to be taken into account in order to achieve optimal acute and long-term results.
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