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Percutaneous Coronary Intervention Using Drug-Eluting Stents Versus Coronary Artery Bypass Grafting for Unprotected Left Main Coronary Artery Stenosis: A Meta-Analysis of Randomized Trials Surgical ineligibility and mortality among patients with unprotected left main or multivessel coronary artery disease undergoing percutaneous coronary intervention New-onset atrial fibrillation after PCI and CABG for left main disease: insights from the EXCEL trial and additional studies Contemporary Use and Trends in Unprotected Left Main Coronary Artery Percutaneous Coronary Intervention in the United States: An Analysis of the National Cardiovascular Data Registry Research to Practice Initiative Impact of coronary anatomy and stenting technique on long-term outcome after drug-eluting stent implantation for unprotected left main coronary artery disease EXCELling in Left Main Intervention Clinical and angiographic outcomes of patients treated with everolimus-eluting stents or first-generation Paclitaxel-eluting stents for unprotected left main disease Differences between the left main and other bifurcations Comparative effectiveness analysis of percutaneous coronary intervention versus coronary artery bypass grafting in patients with chronic kidney disease and unprotected left main coronary artery disease Percutaneous Coronary Intervention of Left Main Disease: Pre- and Post-EXCEL (Evaluation of XIENCE Everolimus Eluting Stent Versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization) and NOBLE (Nordic-Baltic-British Left Main Revascularization Study) Era
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Editorial2018 Oct 1;92(4):651-652.

JOURNAL：Catheter Cardiovasc Interv. Article Link

Volume brings value

Gogas BD, Chen SL.

ABSTRACT


  • What the article teaches

    The article highlights the competency of high volume operators across institutions that despite moving to lower volume centers retain their good clinical outcomes.


  • How it will impact practice

  • Although current U.S. based guidelines suggest a volume of at least 50 PCIs annually for operators to retain clinical competency this estimate may be a poor index to guarantee optimal clinical outcomes.


  • What new research/study would help answer the question

    New studies using a comprehensive definition to define an experienced operator from the Asia‐Pacific—a geographic area that has pioneered in complex coronary interventions—need to elute on the threshold of adequate clinical competency stratified according to clinical complexity.

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