Revascularization for unprotected left main stem coronary artery stenosis: Stenting or surgery

被引：124

作者：

Taggart, David P. ^{[1
]}

Kaul, Sanjay ^{[2
]}

Boden, William E.

Ferguson, T. Bruce, Jr. ^{[3
,4
]}

Guyton, Robert A. ^{[6
]}

Mack, Michael J. ^{[7
]}

Sergeant, Paul T. ^{[9
]}

Shemin, Richard J. ^{[8
]}

Smith, Peter K. ^{[5
]}

Yusuf, Salim ^{[10
]}

机构：

[1] Univ Oxford, Dept Cardiac Surg, John Radcliffe Hosp, Oxford OX3 9DU, England

[2] Cedars Sinai Heart Inst, Div Cardiol, Los Angeles, CA USA

[3] NYU, Dept Cardiovasc Serv, Buffalo Gen & Mil fillmore Hosp, Sch Med & Biomed Sci, Buffalo, NY USA

[4] Eastern Carolina Univ, Div Cardiothorac & vasc surg, Brody Sch Med, Greenville, NC USA

[5] Duke Univ, Med Ctr, Div Cardiothorac Surg, Durham, NC USA

[6] Emory Univ, Sch Med, Div Cardiothorac Surg, Atlanta, GA 30322 USA

[7] Med City Hosp, Cardiopulm Res Sci Technol Inst, Dallas, TX USA

[8] Univ Calif Los Angeles, Div Cardiothorac Surg, Dept Surg, David Geffen Sch Med, Los Angeles, CA USA

[9] Univ Hosp Gasthuisberg, Dept Cardiac Surg, B-3000 Louvain, Belgium

[10] McMaster Univ, Populat Hlth Res Inst, Heart & Stroke Fdn, Hamilton, ON, Canada

来源：

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY | 2008年 / 51卷 / 09期

关键词：

D O I：

10.1016/j.jacc.2007.09.067

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

For coronary artery disease with unprotected left main stem (LMS) stenosis, coronary artery bypass grafting (CABG) is traditionally regarded as the "standard of care" because of its well-documented and durable survival advantage. There is now an increasing trend to use drug-eluting stents for LMS stenosis rather than CABG despite very little high-quality data to inform clinical practice. We herein: 1) evaluate the current evidence in support of the use of percutaneous revascularization for unprotected LMS; 2) assess the underlying justification for randomized controlled trials of stenting versus surgery for unprotected LMS; and 3) examine the optimum approach to informed consent. We conclude that CABG should indeed remain the preferred revascularization treatment in good surgical candidates with unprotected LMS stenosis.

引用

页码：885 / 892

页数：8

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