Revascularization for unprotected left main stem coronary artery stenosis stenting or surgery.


Journal Article (Review)

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.

Full Text

Duke Authors

Cited Authors

  • Taggart, DP; Kaul, S; Boden, WE; Ferguson, TB; Guyton, RA; Mack, MJ; Sergeant, PT; Shemin, RJ; Smith, PK; Yusuf, S

Published Date

  • March 4, 2008

Published In

Volume / Issue

  • 51 / 9

Start / End Page

  • 885 - 892

PubMed ID

  • 18308155

Pubmed Central ID

  • 18308155

Electronic International Standard Serial Number (EISSN)

  • 1558-3597

Digital Object Identifier (DOI)

  • 10.1016/j.jacc.2007.09.067


  • eng

Conference Location

  • United States