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Author(s): Alfonso Ielasi , Alaide Chieffo Added: 3 years ago
A critical stenosis in left main coronary artery (LMCA) is observed in 3–5% of all patients who undergo coronary angiography and in 10–30% of patients who undergo coronary artery bypass grafting (CABG).1 Significant LMCA disease is a high-risk condition because of the extent of jeopardised myocardium. Current practice guidelines recommend CABG as the standard therapy for patients with… View more

Vascular Disease and Surgery

Imaging & Diagnostics
Author(s): Edward McNulty Added: 3 years ago
The debate over the optimal mode of revascularisation for unprotected left main (ULM) coronary artery disease intensified with the advent of drug-eluting stents (DES). Professional society guidelines addressing ULM disease have been revised at an increasing frequency,1,2 the significance of randomised comparisons has been variously interpreted, and observational comparisons have become a… View more

Vascular Disease and Surgery

Intervention
Author(s): Samir R Kapadia , Stephen G Ellis , Nyal Borges Added: 3 years ago
Obstructive unprotected left main coronary artery (ULMCA) disease has been recognised as a high-risk condition since the 1960s owing to the large quantum of myocardium supplied by this system (see Figure 1). In that era, medical therapy was the only available management and 5-year mortality rates exceeded 60 %.1 With the introduction of coronary artery bypass grafting (CABG) it became clear that… View more

Electrophysiology & Arrhythmia

Intervention
Author(s): Rajiv Rampat , David Hildick-Smith Added: 3 years ago
Left main stem (LMS) disease is identified in up to 5 % of diagnostic angiography cases.1 It has major prognostic significance due to the proportion of myocardium at risk. Many years ago, the Coronary Artery Surgery Study (CASS) registry demonstrated the superiority of coronary artery bypass grafting (CABG) over medical therapy with a 5-year mortality reduction from 43 % to 16 % in symptomatic… View more

Vascular Disease and Surgery

Prevention & Chronic Conditions
Author(s): Oluseun Alli , David Holmes Jr Added: 3 years ago
Abstract Patients with complex and multivessel disease present challenging clinical problems in defining treatment strategies. The Synergy between PCI with taxus and cardiac surgery (SYNTAX) trial, which included both a randomised as well as a registry experience has clarified many issues. These include the extent and severity of the disease, the clinical presentation, and the metrics used for… View more

Vascular Disease and Surgery

Prevention & Chronic Conditions
Author(s): Anna Caggegi , Davide Capodanno , Claudia Tamburino , et al Added: 3 years ago
Identifying the most appropriate revascularisation strategy for patients affected by unprotected left main coronary artery (ULMCA) disease has been considered a topic of great interest and discussion in the past few years. Although coronary artery bypass grafting (CABG) is still conventionally regarded as the standard of care for patients with significant ULMCA disease eligible for surgery,… View more

Vascular Disease and Surgery

Prevention & Chronic Conditions
Contemporary Left Main PCI: State-of-the-art Review
Author(s): Refai Showkathali , Radha Priya Yalamanchi Added: 10 months ago

MI/ACS

Intervention
Left Main Coronary Artery Interventions
Author(s): Mirvat Alasnag , Lina Yaqoub , Ammar Saati , et al Added: 3 years ago
Historical Perspective and Early Experience Historically, coronary artery bypass grafting (CABG) surgery has been the gold standard treatment for left main coronary artery (LMCA) disease. However, with the developments and advancements in the interventional cardiology field, percutaneous coronary intervention (PCI) has become a safe alternative management option to CABG in select patients. Today… View more

Vascular Disease and Surgery

Intervention
Use of Intravascular Ultrasound Imaging in Percutaneous Coronary Intervention to Treat Left Main Coronary Artery Disease
Author(s): Giovanni Luigi De Maria , Adrian P Banning Added: 3 years ago
Detection of obstructive disease of the left main coronary artery (LMCA) is relatively unusual in the catheterisation laboratory, as it accounts for approximately 4 % of all coronary angiograms, with isolated LMCA disease observed in only 5–10 % of these cases.1 Intervention to the LMCA is, however, notable compared to the treatment of coronary stenosis elsewhere in the coronary tree. First,… View more

Vascular Disease and Surgery

Imaging & Diagnostics