Unprotected Left Main PCI
Unprotected Left Main PCI
Unprotected left main coronary artery (ULMCA) disease is seen in 4% of patients who undergo angiography. Though coronary artery bypass graft surgery has traditionally been the preferred approach to revascularization, recent major society guidelines support the use of percutaneous coronary intervention (PCI) in properly selected patients. This article provides an overview of recent studies evaluating the efficacy of ULMCA PCI and looking at contemporary approaches to the evaluation and percutaneous treatment of ULMCA disease. The ongoing EXCEL trial will help elucidate the role of ULMCA PCI in the treatment of left main disease compared with coronary artery bypass graft surgery.
Unprotected left main coronary artery (ULMCA) disease is seen in approximately 4% of patients who undergo angiography. Revascularization in these patients is recommended due to a significantly higher mortality rate in those treated medically. While coronary artery bypass graft (CABG) surgery has traditionally been the preferred mode of revascularization, there are increasing data that percutaneous coronary intervention (PCI) is often a viable option, and recent guidelines now suggest that PCI be considered in appropriate patients. The purpose of this article is to provide an updated overview of the current understanding of the evaluation and treatment of ULMCA disease, with a particular focus on what recent clinical studies have added to this body of data.
Abstract and Introduction
Abstract
Unprotected left main coronary artery (ULMCA) disease is seen in 4% of patients who undergo angiography. Though coronary artery bypass graft surgery has traditionally been the preferred approach to revascularization, recent major society guidelines support the use of percutaneous coronary intervention (PCI) in properly selected patients. This article provides an overview of recent studies evaluating the efficacy of ULMCA PCI and looking at contemporary approaches to the evaluation and percutaneous treatment of ULMCA disease. The ongoing EXCEL trial will help elucidate the role of ULMCA PCI in the treatment of left main disease compared with coronary artery bypass graft surgery.
Introduction
Unprotected left main coronary artery (ULMCA) disease is seen in approximately 4% of patients who undergo angiography. Revascularization in these patients is recommended due to a significantly higher mortality rate in those treated medically. While coronary artery bypass graft (CABG) surgery has traditionally been the preferred mode of revascularization, there are increasing data that percutaneous coronary intervention (PCI) is often a viable option, and recent guidelines now suggest that PCI be considered in appropriate patients. The purpose of this article is to provide an updated overview of the current understanding of the evaluation and treatment of ULMCA disease, with a particular focus on what recent clinical studies have added to this body of data.
Source...