title: Update on percutaneous intervention for left main coronary artery stenosis.
abstract: Percutaneous coronary intervention (PCI) using drug-eluting stents (DES) is currently considered as a viable alternative to coronary artery bypass graft surgery (CABG) for selected patients with left main coronary artery disease. The updated results of the landmark randomized trials comparing CABG versus PCI demonstrated comparable 5-year outcomes and are in line with the current guidelines that designate PCI as a reasonable treatment in this disease subset. Given that the completed randomized trials did not include contemporary DESs, the upcoming results of the ongoing trials evaluating the performance of new-generation DES compared with CABG (such as the EXCEL trial), may further help to clarify the current role and future recommendations of PCI for left main coronary artery disease. Apart from the recent stent technology, further improvements in outcomes after PCI may be possible when it is used with an integrated approach that combines functional concepts for decision-making, adjunctive imaging support and optimal pharmacotherapies.
authors.affiliation: Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Pil Hyung
authors.initials: PH
authors.lastname: Lee
authors.forename: Jung-Min
authors.initials: JM
authors.lastname: Ahn
authors.forename: Seung-Jung
authors.initials: SJ
authors.lastname: Park
mesh_terms: D000068456:Clinical Studies as Topic; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D015607:Stents; D018084:Ultrasonography, Interventional
keywords: bifurcation; drug-eluting stent; fractional flow reserve; intravascular ultrasound; left main coronary artery; outcomes; percutaneous coronary intervention