The left main facts: faced, spun, but alas too few.
Bypass surgery has been shown to prolong life in patients with significant left main stenosis compared with medical therapy and is the current standard of care. Recent registry data suggest that stenting may offer intermediate-term results similar to surgery, although with a greater need for repeat revascularization. Drug-eluting stents appear to improve the outcomes of stenting. Over 20% of patients with left main disease currently receive stents, and there is need for ongoing randomized controlled trials to validate this approach. It is essential that such patients receive balanced counseling as to revascularization options.
Brinker
Jeff
J
The Johns Hopkins Hospital, Baltimore, Maryland 21287, USA. jbrinker@jhmi.edu
D015906:Angioplasty, Balloon, Coronary; D001026:Coronary Artery Bypass / Q000009:adverse effects; D023903:Coronary Restenosis / Q000209:etiology*; D023921:Coronary Stenosis / Q000601:surgery / Q000628:therapy*; D054855:Drug-Eluting Stents / Q000009:adverse effects; D006801:Humans; D016896:Treatment Outcome