Key result
Review summarizes current evidence, PCI techniques, and imaging guidance for managing LMCAD.
Why the study?
Although PCI is guideline-supported for left main coronary artery disease of low and intermediate complexity, it remains controversial and its long-term outcomes have been questioned.
This review highlights the evolving role of PCI with imaging and physiology guidance as a viable alternative to CABG for low and intermediate complexity left main coronary artery disease.
Offers updated synthesis for left main PCI decisions; leaves open need for new RCTs on imaging guidance.
The 'gold standard' in the management of left main coronary artery disease has historically been coronary artery bypass surgery. Recent innovations in drug-eluting stent technology coupled with the increasing utility of physiology and imaging guidance for procedures have led to an evolving role of percutaneous coronary intervention in left main disease of low and intermediate anatomical complexity. This revascularization modality carries the clear advantage of being less invasive and significantly reduced recovery times. This practice is currently supported by international guidelines, however, it remains a controversial topic in the field of interventional cardiology, and the long-term outcomes of a percutaneous strategy have been questioned. This review describes the current evidence base for the assessment and choice of intervention in left main coronary artery disease. The percutaneous revascularization techniques and use of imaging to optimize procedures and improve clinical outcomes have been discussed.
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Mailey et al. (2021) conducted a review in Left main coronary artery disease. Percutaneous coronary intervention vs. Coronary artery bypass surgery was evaluated. This review summarizes the current evidence base, percutaneous revascularization techniques, and imaging guidance for the management of left main coronary artery disease.
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