Five-year outcome of consecutive unprotected left main percutaneous coronary interventions

The management of left main coronary artery (LMCA) disease has evolved over the past two decades. Historically, coronary artery bypass grafting (CABG) surgery has been the gold standard for the treatment of LMCA disease. However, with the advancements in percutaneous coronary interventions (PCIs) and stent technology, PCI in select patients has achieved comparable outcomes to CABG. As such, this has led to changes in the American College of Cardiology and European Society of Cardiology guidelines, which recommend that PCI might be an alternative to CABG in select patients. In this review article, we describe the historical perspective and early experience with coronary interventions of LMCA disease, landmark clinical trials and their effect on guidelines, and the role of intravascular imaging in the management of LMCA lesions.

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P786The relationship between concomitant multi-vessel disease and periprocedural outcomes of percutaneous coronary interventions within left main coronary artery (from ORPKI registry)

European Heart Journal ◽

10.1093/eurheartj/ehy564.p786 ◽

2018 ◽

Vol 39 (suppl_1) ◽

Author(s):

R Januszek ◽

A Dziewierz ◽

Z Siudak ◽

T Rakowski ◽

A Pawlik ◽

...

Keyword(s):

Coronary Artery ◽

Left Main Coronary Artery ◽

Percutaneous Coronary Interventions ◽

Left Main ◽

Vessel Disease ◽

Coronary Interventions ◽

Percutaneous Coronary

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Emergency percutaneous coronary interventions for unprotected left main stenoses: immediate and long term follow up

Heart ◽

10.1136/hrt.2003.021378 ◽

2004 ◽

Vol 90 (9) ◽

pp. 1067-1068 ◽

Cited By ~ 3

Author(s):

B R G Brueren

Keyword(s):

Percutaneous Coronary Interventions ◽

Left Main ◽

Coronary Interventions ◽

Percutaneous Coronary ◽

Long Term Follow Up

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Current representation of endovascular treatment of patients with left main coronary artery disease

Cardiosomatics ◽

10.26442/cs45264 ◽

2016 ◽

Vol 7 (2) ◽

pp. 56-59

Author(s):

V. Yu Vlasov ◽

B. A Rudenko ◽

A. S Shanoyan ◽

V. P Mazaev ◽

A. Sh Akhadova ◽

...

Keyword(s):

Coronary Artery ◽

Left Main Coronary Artery ◽

Artery Bypass ◽

Drug Eluting Stent ◽

Percutaneous Coronary Interventions ◽

Left Main ◽

Level Of Evidence ◽

Coronary Interventions ◽

Stent Restenosis ◽

Percutaneous Coronary

Coronary artery bypass grafting (CABG) is known as the gold standard treatment of unprotected left main coronary artery (LMCA) disease and has the highest level of evidence in European and American recommendations. However development of endovascular methods of treatment, and first of all decrease of in-stent-restenosis allow us to consider angioplasty and stenting of LMCA as an alternative method to CABG. The comparative world analysis of results of percutaneous coronary interventions and CABG is provided in article. It tells also how efficiency of percutaneous coronary interventions depends on such factors as lesion localization, diabetes, type of drug-eluting stent.

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CORONARY INTERVENTIONS ON LEFT MAIN CORONARY ARTERY — SHORT-TERM RESULTS OF ROUTINE CLINICAL PRACTICE

Kharkiv Surgical School ◽

10.37699/2308-7005.2.2020.14 ◽

2020 ◽

pp. 70-75

Author(s):

I. V. Polivenok ◽

M. S. Belimenko

Keyword(s):

Coronary Artery ◽

Coronary Bypass ◽

Circulatory Support ◽

Percutaneous Coronary Interventions ◽

Left Main ◽

Short Term ◽

Coronary Syndrome ◽

Coronary Interventions ◽

Percutaneous Coronary ◽

Significant Difference

Summary. Left main (LM) coronary artery lesions occurring in 4.8-9 % of patients on coronary angiography, represent a serious clinical problem with a quite aggressive revascularization strategy. Despite the growing evidence of the efficacy and safety of percutaneous coronary interventions (PCI) on LM, coronary bypass surgery remains the dominant method of revascularization in many hospitals. Material and methods. The authors presented short-term results of LM PCI in 66 consecutive patients in one center. Results. LM PCI accounted for 4.9 % of the total number of percutaneous coronary interventions. 67.2 % of PCI were performed by radial access, two-stent strategies were used in 10.8 %, mechanical circulatory support — in 7.5 %, and intracoronary imaging – in 1.5 % of cases. Hospital mortality was 4.5 %, the complications rate — 13.6 %. There was no significant difference in access, technical aspects of the procedure, the number of complications and mortality rate between elective patients and patients with an acute coronary syndrome. Conlusion. LM PCI can be performed routinely in experienced coronary programs with acceptable short-term outcomes. Additional efforts are needed from the hospital administrations and professional societies to increase the use of coronary imaging in order to improve the long-term outcomes of LM PCI.

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