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Revascularization in Patients With Left Main Coronary Artery Disease and Left Ventricular Dysfunction 3-Year Outcomes of the ULTIMATE Trial Comparing Intravascular Ultrasound Versus Angiography-Guided Drug-Eluting Stent Implantation Comparison of inhospital mortality, length of hospitalization, costs, and vascular complications of percutaneous coronary interventions guided by ultrasound versus angiography Contribution of stent underexpansion to recurrence after sirolimus-eluting stent implantation for in-stent restenosis Successful bailout stenting strategy against lethal coronary dissection involving left main bifurcation Transcatheter Aortic Valve Replacement vs Surgical Replacement in Patients With Pure Aortic Insufficiency Criteria for Iron Deficiency in Patients With Heart Failure Genotyping to Guide Clopidogrel Treatment: An In-Depth Analysis of the TAILOR-PCI Trial Longitudinal Assessment of Vascular Function With Sunitinib in Patients With Metastatic Renal Cell Carcinoma Why and How to Measure Aortic Valve Calcification in Patients With Aortic Stenosis
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Review Article2018 Mar 23;20(5):29.

JOURNAL：Curr Cardiol Rep. Article Link

Operator Experience and Outcomes After Left Main Percutaneous Coronary Intervention

Kanmanthareddy A, Anugula D, Kar B. Keywords: Hemodynamic support; High-risk intervention; Left main; Operator experience; Percutaneous coronary intervention

ABSTRACT

PURPOSE OF REVIEW - This review was performed with the goal of summarizing the role of operator experience in the treatment of severe left main stenosis by percutaneous intervention techniques.


RECENT FINDINGS - The Evaluation of XIENCE versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization (EXCEL) trial demonstrated that percutaneous coronary intervention and coronary artery bypass grafting had similar clinical outcomes for severe left main disease. However, PCI of the left main coronary stenosis is considered to be a high-risk intervention because of the large area of myocardium at jeopardy that can quickly cause hemodynamic compromise. Operator experience and familiarity with the use of hemodynamic support devices, plaque modification techniques, and intravascular imaging tools is associated with better clinical outcomes. In patients with severe left main stenosis undergoing percutaneous coronary intervention by high-volume operators, the clinical outcomes are superior.
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