Why the study?
CABG has historically been the gold standard for left main coronary artery disease, but technological advancements have established PCI as a safe and reasonable alternative with comparable outcomes.
Contemporary percutaneous coronary intervention, guided by intravascular imaging and physiological assessment, is a safe and reasonable alternative to coronary artery bypass surgery for left main coronary artery disease.
Supports contemporary PCI for left main disease; hypothesis-generating pending dedicated randomized trials.
The majority of the left ventricular myocardium is supplied by the left main coronary artery. Atherosclerotic obstruction of the left main coronary artery therefore leads to significant myocardial jeopardy. Coronary artery bypass surgery (CABG) has been the gold standard for left main coronary artery disease in the past. However, advancements in technology have established percutaneous coronary intervention (PCI) as a standard, safe and reasonable alternative to CABG, with comparable outcomes. Contemporary PCI of left main coronary artery disease comprises careful patient selection, accurate technique guided by either intravascular ultrasound or optical coherence tomography and - if necessary - physiological assessment using fractional flow reserve. This review focuses on current evidence from registries and randomised trials comparing PCI with CABG, procedural tips and tricks, adjuvant technologies and the triumph of PCI.
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Showkathali et al. (2023) studied this question.
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