Comparison of Percutaneous Versus Surgical Revascularization of Severe Unprotected Left Main Coronary Stenosis in Matched Patients

Long-Term Outcomes of Intervention for Unprotected Left Main Coronary Artery Stenosis Coronary Stenting vs Coronary Artery Bypass Grafting

“…Brener et al demonstrates that higher EuroSCORE and diabetes are independent predictors of mortality at 3 years in patients undergoing revascularization for ULMCA stenosis. 32 In the present study, advanced age and extensive coronary artery atherosclerosis independently predicted cardiac death after the index procedure. Given its lower peri-procedural mortality rate in comparison with CABG, PCI is recommended for patients of advanced age or with limited lifespan because of underlying comorbidities.…”

Percutaneous Coronary Intervention versus Coronary-Artery Bypass Grafting for Severe Coronary Artery Disease

“…[10][11][12] Studies comparing PCI involving drugeluting stents with CABG have generally been smaller and nonrandomized. [13][14][15][16][17][18][19][20][21][22][23][24] Data from randomized, controlled trials of drug-eluting stents as compared with bare-metal stents have shown significant reductions in the rate of repeat intervention, with similar rates of death and myocardial infarction. 25 These improvements have led to expanded use of PCI in patients with complex coronary anatomical features, though most randomized trials comparing drugeluting stents and bare-metal stents excluded such patients.…”

Bayesian Methods Affirm the Use of Percutaneous Coronary Intervention to Improve Survival in Patients With Unprotected Left Main Coronary Artery Disease

“…A review of the 2011 PCI guideline and Data Supplements 3 and 4 12 revealed that 4 randomized trials [13][14][15][16] and 8 cohort studies [17][18][19][20][21][22][23][24] comprised the evidence for the new Class IIa recommendation for PCI to improve survival in patients with ULMCAD, whereas 7 older studies formed the knowledge base to show that CABG confers a survival advantage over MT in patients with ULMCAD. [2][3][4][5][6][7][8] The 19 studies used predefined enrollment criteria and were published in peer-reviewed journals.…”

“…Evidence for the second premise comes from 4 randomized trials [13][14][15][16] and 8 cohort studies, [17][18][19][20][21][22][23][24] all reported during the past 7 years.…”