J Cardiovasc Interv.
2023 Jul;2(3):121-136. 10.54912/jci.2022.0029.
Past, Present, and Future of Left Main Coronary Artery PCI
- Affiliations
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- 1Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- KMID: 2560940
- DOI: http://doi.org/10.54912/jci.2022.0029
Abstract
- Left main coronary artery (LMCA) disease is a clinically challenging subset, and standard treatment of revascularization has been via coronary artery bypass grafting (CABG). However, the percutaneous coronary intervention (PCI) outcomes for unprotected LMCA disease have improved due to developments in stent technologies, technical enhancement, intravascular imaging, and adjunctive medical therapy. Thus, PCI for an LMCA lesion is an acceptable alternative revascularization strategy in selected patients with LMCA disease patients with the widespread use of drug-eluting stents. Several randomized trial and meta-analysis showed no difference in all-cause death between CABG and PCI. Therefore, the optimal revascularization strategy for LMCA disease should consider multiple factors, including coronary artery complexity, the possibility of complete revascularization, and the perioperative risk of each patient with adequate discussion in multidisciplinary approach.
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