Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Treatment of Unprotected Left Main Stenosis

被引：1

作者：

Taha, Yasir ^{[1
]}

Patel, Rajan A. G. ^{[2
]}

Bagai, Jayant ^{[3
]}

Sachdeva, Rajesh ^{[1
]}

Kumar, Gautam ^{[4
]}

Prasad, Anand ^{[5
]}

Nathan, Sandeep ^{[6
]}

Paul, Timir K. ^{[7
]}

机构：

[1] Morehouse Sch Med, Atlanta, GA 30310 USA

[2] Ochsner Med Ctr, New Orleans, LA USA

[3] Vanderbilt Univ, Med Ctr, Nashville, TN USA

[4] Emory Univ, Sch Med, Atlanta, GA USA

[5] Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX USA

[6] Univ Chicago, Chicago, IL 60637 USA

[7] East Tennessee State Univ, Dept Internal Med, Div Cardiol, 329 N State Franklin Rd, Johnson City, TN 37604 USA

来源：

CURRENT CARDIOLOGY REPORTS | 2019年 / 21卷 / 05期

关键词：

Left main; Percutaneous coronary intervention; Coronary artery bypass graft; FRACTIONAL FLOW RESERVE; DOUBLE KISSING CRUSH; DRUG-ELUTING STENTS; LONG-TERM MORTALITY; INTRAVASCULAR ULTRASOUND; RANDOMIZED-TRIALS; 5-YEAR OUTCOMES; SYNTAX SCORE; SURGERY; DISEASE;

D O I：

10.1007/s11886-019-1113-0

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Purpose of ReviewThis article reviews the latest data on unprotected left main (ULM) percutaneous coronary intervention (PCI) versus coronary artery bypass graft (CABG) surgery, with a focus on the NOBLE and EXCEL trials.Recent FindingsIn EXCEL trial, the primary endpoint at 3years was 15.4% in the PCI group and 14.7% in the CABG group (p=0.02 for non-inferiority of PCI versus CABG). In NOBLE, the primary endpoint at 5years was 28% and 18% for PCI and CABG, respectively (HR 1.51, CI 1.13-2.0, which did not meet the criteria for non-inferiority of PCI to CABG; p for superiority of CABG was 0.0044). Higher repeat revascularization and non-procedural myocardial infarction were noted in PCI group but there was no difference in all-cause or cardiac mortality between the two groups.SummaryA heart team approach with appropriate patient selection, careful assessment of LM lesions, and meticulous procedural technique makes PCI a valid alternative to CABG for ULM stenosis.

引用

页数：8

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