Abstract

Current guidelines recommend coronary artery bypass grafting (CABG) as the treatment of choice for patients who have unprotected left main coronary artery disease (ULMCA). Several registries and two randomised controlled clinical trials have shown that hard end-points such as cardiac death, myocardial infarctions and cerebrovascular events are similar following percutaneous coronary intervention (PCI) with drug-eluting stent (DES) implantation compared with CABG. However, current American and European guidelines do not endorse PCI as an appropriate alternative to CABG for patients with ULMCA. In this article we review the current evidence on PCI with DES for ULMCA stenosis treatment and propose future directions in this evolving topic of great interest.

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