Coronary Artery Bypass Grafting Versus Percutaneous Coronary Intervention in Patients With Non–ST-Elevation Myocardial Infarction and Left Main or Multivessel Coronary Disease

2019 ◽  
Vol 123 (5) ◽  
pp. 717-724 ◽  
Author(s):  
Pedro Freitas ◽  
Márcio Madeira ◽  
Luís Raposo ◽  
Sérgio Madeira ◽  
João Brito ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Artery Bypass ◽  
Coronary Intervention ◽  
Bypass Grafting ◽  
Left Main ◽  
Percutaneous Coronary ◽  
St Elevation

scholarly journals The EXCEL Trial: The Surgeons’ Perspective

2020 ◽  
Vol 15 ◽  
Author(s):  
Marjan Jahangiri ◽  
Krishna Mani ◽  
Martin T Yates ◽  
Justin Nowell
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
Coronary Intervention ◽  
Bypass Grafting ◽  
Left Main ◽  
Percutaneous Coronary ◽  
Left Main Stem Disease

There have been several investigations comparing the efficacy of percutaneous coronary intervention and coronary artery bypass grafting surgery for treatment of left main stem disease. This includes the Evaluation of XIENCE versus Coronary Artery Bypass Graft Surgery for Effectiveness of Left Main Revascularizaton (EXCEL) trial, which has garnered significant controversy surrounding its experimental design and reporting of its results. The authors review the methodology, results, caveats and statements on the EXCEL trial. They also review the other trials in the management of left main stem disease comparing percutaneous coronary intervention with coronary artery bypass grafting, as well as the SYNTAX score and its role in future guidelines for revascularisation. These findings have significant implications for current practice, influencing the growing role for multidisciplinary team meeting and allowing clinicians and patients to make the right choice.

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