Stents versus Coronary-Artery Bypass Grafting for Left Main Coronary Artery Disease

Seung, Ki Bae; Park, Duk‐Woo; Kim, Young‐Hak; Lee, Seung-Whan; Lee, Cheol Whan; Hong, Myeong‐Ki; Park, Seong-Wook; Yun, Sung‐Cheol; Gwon, Hyeon‐Cheol; Jeong, Jin‐Ok; Jang, Yangsoo; Kim, Hyo–Soo; Kim, Pum Joon; Seong, In‐Whan; Park, Hun Sik; Ahn, Taehoon; Chae, In‐Ho; Tahk, Seung‐Jea; Chung, Wook-Sung; Park, Seung‐Jung

doi:10.1056/nejmoa0801441

Cited by 439 publications

(309 citation statements)

References 22 publications

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“…[147][148][149] Several studies comparing CABG to PCI, however, indicated that the advantage of CABG consists primarily of fewer repeat revascularizations. 139,[149][150][151][152][153][154][155] The study by Brener et al 156 indicates no significant mortality difference between PCI and CABG after 3 years of follow-up. Longer-term follow-up is needed.…”

Section: Recommendations For Pci For Unprotected Left Main Coronary Amentioning

confidence: 99%

2009 Focused Updates: ACC/AHA Guidelines for the Management of Patients With ST‐Elevation Myocardial Infarction (Updating the 2004 Guideline and 2007 Focused Update) and ACC/AHA/SCAI Guidelines on Percutaneous Coronary Intervention (Updating the 2005 Guideline and 2007 Focused Update)

Kushner¹,

Hand

Smith³

et al. 2009

Cathet Cardio Intervent

113

102

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Section: Recommendations For Pci For Unprotected Left Main Coronary Amentioning

confidence: 99%

2009 Focused Updates: ACC/AHA Guidelines for the Management of Patients With ST‐Elevation Myocardial Infarction (Updating the 2004 Guideline and 2007 Focused Update) and ACC/AHA/SCAI Guidelines on Percutaneous Coronary Intervention (Updating the 2005 Guideline and 2007 Focused Update)

Kushner¹,

Hand

Smith³

et al. 2009

Cathet Cardio Intervent

113

102

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“…At 3 years, the risk of restenosis requiring target-vessel revascularization was significantly higher in patients that received stents than in those who underwent surgical revascularization, but there was no significant difference in the risk of death or in the cumulative endpoint of death, myocardial infarction, or stroke between the two groups. While the need for repeat revascularization was greater after bare metal stent implantation as compared to drug-eluting stents, there was a slight increase in death and in the composite end point in those patients that received drug-eluting stents [3]. Additional studies have also compared drug-eluting stents and bare metals stents in the setting of unprotected LM interventions.…”

Section: Discussionmentioning

confidence: 99%

Palliative Combined Percutaneous Balloon Aortic Valvuloplasty and Unprotected Left Main Stenting in End Stage Renal Disease

Dorfman¹,

Aqel²

2009

CCR

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Abstract:With the aging population and high prevalence of atherosclerosis, an increasing number of patients presenting with heart failure and angina are found to have severe coronary artery disease and severe valvular disease. These patients tend to have multiple co-morbidities such as end stage renal disease and are considered high-risk for surgery. In patients with severe coronary artery disease, severe aortic stenosis, and heart failure with depressed left ventricular systolic function, the options are limited as they are not usually offered surgery, but palliative percutaneous high-risk procedures might be a viable alternative.Though long term results after balloon aortic valvuolpasty are not promising, there is a role for these procedures in highrisk inoperable patients for either palliation or as a bridge to surgery. Unprotected left main percutaneous interventions are also feasible with low complication rates. This review provides mounting evidence that it is reasonable to perform combined palliative balloon aortic valvuolpasty and high-risk coronary artery stenting in certain inoperable patients. An illustrative case is presented that extends the findings of the current literature and demonstrates that combined balloon aortic valvuolpasty and left main stenting could be a safe and effective alternative in the setting of heart failure, left ventricular dysfunction, and end stage renal disease.Keywords: Aortic stenosis, critical left main disease, percutaneous balloon aortic valvuoplasty, unprotected left main stenting, palliative high risk percutaneous interventions. CASE REPORTA 56 year-old African American female with end stage renal disease on hemodialysis was admitted for worsening dsypnea and exertional chest pain. Her shortness of breath had begun 1-2 years ago but had progressed rapidly over the past few months. Presently she has dyspnea on exertion with minimal activity, severe orthopnea, paroxysmal nocturnal dyspnea, and marked peripheral edema and was considered to be in New York Heart Association class IV heart failure.Past medical history was notable for congestive heart failure with preserved left ventricular (LV) function, end stage renal disease on hemodialysis, systemic arterial hypertension, and diabetes type 2. On admission the patient was on a beta blocker, ace inhibitor, non-dihydropyridine calcium channel blocker, hydralazine, a statin, and aspirin.She was afebrile with a heart rate of 94 beats/min, blood pressure 148/75 mm Hg, and a respiratory rate 28 breaths/min with 94% oxygen saturation on room air. Her exam was otherwise notable for jugular venous pressure at about 13 cm H 2 0, delayed carotid upstrokes, and bibasilar crackles. Cardiac exam was notable for a normal S1 and a soft P2, a focal, non-displaced point of maximal impulse with no lifts, heaves, or thrills, and a III/VI systolic ejection murmur that peaked late in systole and was audible at the Transthoracic echocardiography revealed a LV ejection fraction of 35%, preserved right ventricular function, mild mitral regurgit...

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“…Clinical variables entered into the propensity model were age, body weight, gender, Child-Pugh score and ECOG-PS, which indicated variables we frequently take into account in daily clinical practice when we decide initial dose of sorafenib (20). Subsequently, a one-to-one match between the standard-dose group (800 mg/day of sorafenib) and the half-dose group (400 mg/day of sorafenib) was obtained by using the nearestneighbor matching method (21,22).…”

Section: Standard-dose Groupmentioning

confidence: 99%

Comparison of standard-dose and half-dose sorafenib therapy on clinical outcome in patients with unresectable hepatocellular carcinoma in field practice: A propensity score matching analysis

Nishikawa

Osaki

Endo

et al. 2014

International Journal of Oncology

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Stents versus Coronary-Artery Bypass Grafting for Left Main Coronary Artery Disease

Cited by 439 publications

References 22 publications

2009 Focused Updates: ACC/AHA Guidelines for the Management of Patients With ST‐Elevation Myocardial Infarction (Updating the 2004 Guideline and 2007 Focused Update) and ACC/AHA/SCAI Guidelines on Percutaneous Coronary Intervention (Updating the 2005 Guideline and 2007 Focused Update)

2009 Focused Updates: ACC/AHA Guidelines for the Management of Patients With ST‐Elevation Myocardial Infarction (Updating the 2004 Guideline and 2007 Focused Update) and ACC/AHA/SCAI Guidelines on Percutaneous Coronary Intervention (Updating the 2005 Guideline and 2007 Focused Update)

Palliative Combined Percutaneous Balloon Aortic Valvuloplasty and Unprotected Left Main Stenting in End Stage Renal Disease

Comparison of standard-dose and half-dose sorafenib therapy on clinical outcome in patients with unresectable hepatocellular carcinoma in field practice: A propensity score matching analysis

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