The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

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Contemporary considerations in left main stem treatment

EuroIntervention 2017;13:1144-1147. DOI: 10.4244/EIJV13I10A179

Department of Cardiovascular Sciences, University of Leicester, Leicester Biomedical Research Centre, University of Leicester NHS Trust, Leicester, United Kingdom


Percutaneous interventional treatment for disease affecting the left main stem has historically been considered problematic for a number of reasons. Firstly its site, at the origin of the coronary tree, means that any percutaneous therapy has to be absolutely robust. A post-procedural occlusion of a mid or distal circumflex or right coronary artery, while less than ideal, carries far less risk than occlusive stent thrombosis affecting the left main stem. Only recently has stenting become predictably safe through advances in techniques, devices and adjunctive pharmacology. Secondly, left main stem disease is heterogeneous. Treating ostial/shaft disease is very different ...

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