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Long-term outcomes following mini-crush versus culotte stenting for the treatment of unprotected left main disease: insights from the Milan and New-Tokyo (MITO) registry Subclinical and Device-Detected Atrial Fibrillation: Pondering the Knowledge Gap: A Scientific Statement From the American Heart Association Intravascular ultrasound predictors of angiographic restenosis after sirolimus-eluting stent implantation Long-Term Outcomes After PCI or CABG for Left Main Coronary Artery Disease According to Lesion Location Differential prognostic impact of treatment strategy among patients with left main versus non-left main bifurcation lesions undergoing percutaneous coronary intervention: results from the COBIS (Coronary Bifurcation Stenting) Registry II Long-term outcomes with use of intravascular ultrasound for the treatment of coronary bifurcation lesions Role of intravascular ultrasound in patients with acute myocardial infarction undergoing percutaneous coronary intervention Ticagrelor versus clopidogrel in patients with acute coronary syndromes Intracoronary stenting without anticoagulation accomplished with intravascular ultrasound guidance Genotyping to Guide Clopidogrel Treatment: An In-Depth Analysis of the TAILOR-PCI Trial
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Review Article2017 Oct 1;2(10):1089.

JOURNAL：JAMA Cardiol. Article Link

Left Main Revascularization in 2017: Coronary Artery Bypass Grafting or Percutaneous Coronary Intervention?

Kirtane AJ, Bonow RO. Keywords: CABG; PCI; left main revascularization

ABSTRACT

It can be argued that severe left main coronary artery (LMCA) disease represents the only anatomic subtype of coronary artery disease for which there is clear and unequivocal prognostic evidence in favor of coronary revascularization across the spectrum of clinical presentation—from stable ischemic heart disease to acute coronary syndrome. For decades, the standard approach to LMCA revascularization has been through coronary artery bypass grafting (CABG) given its ability to safely and effectively achieve complete revascularization. More recently, revascularization through percutaneous coronary intervention (PCI) has been proposed as an alternative to CABG for traditionally surgical anatomy. Predicate data from the Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) clinical trial and other clinical trials have suggested that the LMCA may be ideally suited to maximize the potential relative benefits of PCI (less invasiveness, ideally suited for larger vessels with more focal disease) while mitigating its relative disadvantages (restenosis and stent thrombosis, especially when tackling diffuse disease). However, until recently, the prospective evidence base on which this assertion was based was limited.
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