Fernando Cura2014-10-30 Jefe de Cardiología Intervencionista y Terapéuticas Endovasculares ICBA – Argentina
Revascularization vs. Deferral of Physiologically Significant Lesions in the Left Main Coronary Artery
Most randomized studies on decision-making in coronary artery disease revascularization exclude left main coronary artery disease (LMCAD), as did the ISCHEMIA Study. On the other hand, the benefits of functionally assessing lesions, proven in studies such as FAME, emphasize the importance of this tool in guiding revascularization decisions. However, there is still little understanding of<a href="https://solaci.org/en/2023/12/06/revascularization-vs-deferral-of-physiologically-significant-lesions-in-the-left-main-coronary-artery/" title="Read more" >...</a>
Left Main Revascularization: 12 Year Registry in Canada
The current indication for severe left main lesion continues to be coronary artery bypass graft surgery (CABG) but percutaneous coronary intervention (PCI) has come far in this territory thanks to increasing operator experienced and the use of IVUS during procedures. At present, left main disease have a Class IIa indication in the American guidelines when<a href="https://solaci.org/en/2023/03/02/left-main-revascularization-12-year-registry-in-canada/" title="Read more" >...</a>
Is the Use of iFR for the Deferral of Left Main Coronary Artery Lesions Safe?
Deferral of left main coronary artery lesions using instantaneous wave-free ratio (iFR) seems to be safe. At the least, patients with deferred lesions had similar long-term prognosis to that of patients who underwent revascularization based on that same indicator. Left main coronary artery lesions were universally excluded from studies including medical treatment among the therapeutic<a href="https://solaci.org/en/2020/06/23/is-the-use-of-ifr-for-the-deferral-of-left-main-coronary-artery-lesions-safe/" title="Read more" >...</a>
SOLACI Webinar – 18/06- Left Main Coronary Artery PCI 360: Clinical Case, Technique and Evidence
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Soon after the EXCEL “Scandal” the NOBLE 5-year Outcomes Come Out: Mere Coincidence?
There is no such thing as coincidence, at least not for the evidence-based medical science. This is what the NOBLE 5-year outcomes, soon to be published in the Lancet, seem to say, in line with the BBC exposé of the EXCEL study. The NOBLE study randomized patients with left main disease to compare PCI vs<a href="https://solaci.org/en/2020/01/08/soon-after-the-excel-scandal-the-noble-5-year-outcomes-come-out-mere-coincidence/" title="Read more" >...</a>
Left Main PCI Technique Could Change DAPT Duration
Up to 20% of patients undergoing left main PCI require a 2-stent technique, and this number should most likely grow after the DKCRUSH-V outcomes. However, this study contradicts the DKCRUSH-V and brings us back to “the simpler the better”, since patients undergoing 1 stent left main PCI presented less revascularization and less target vessel failure<a href="https://solaci.org/en/2019/01/10/left-main-pci-technique-could-change-dapt-duration/" title="Read more" >...</a>
More Evidence For Left Main PCI
Courtesy of Dr. Carlos Fava. Left main coronary artery disease (LMD), has historically been treated with myocardial revascularization surgery (CABG), but for some years now, and with the development of new drug eluting stents (DES), percutaneous coronary intervention (PCI) has been gathering support in this challenging territory. The study analyzed the SYNTAX and PRECOMBAT<a href="https://solaci.org/en/2016/11/10/more-evidence-for-left-main-pci/" title="Read more" >...</a>
Rehospitalization After Treatment of Left Main Coronary Artery Disease and Its Prognosis: Sub-Analysis of the EXCEL Study
Individual randomized studies have shown variable results regarding the mortality risk following treatment of left main coronary artery disease (LMCAD), either through percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). However, upon assessment of the latest meta-analyses (with matched data), similar risks of all-cause and cardiovascular mortality have been reported for both groups.<a href="https://solaci.org/en/2024/03/21/rehospitalization-after-treatment-of-left-main-coronary-artery-disease-and-its-prognosis-sub-analysis-of-the-excel-study/" title="Read more" >...</a>
Left Main Coronary Artery PCI: In What Scenario Could We Not Use IVUS?
Lesions in the left main coronary artery (LMCA) continue to pose a significant challenge. The use of coronary imaging before percutaneous coronary implantation (PCI) has proven useful in analyzing the lesion, identifying the presence and location of calcification, and determining lesion length in the LMCA, the left anterior descending artery, and the circumflex artery. Various<a href="https://solaci.org/en/2023/10/10/left-main-coronary-artery-pci-in-what-scenario-could-we-not-use-ivus/" title="Read more" >...</a>