IS LEFT MAIN CORONARY STENTING PREFERABLE TO CABG?

In “Case 2—2006Catastrophic Cardiovascular Collapse During Carotid Endarterectomy” JCTVA Volume 20Issue 2, Pages 259-268 (April 2006),” we suggested that PCI was becoming an option for left main CAD Rx, whereas traditional teaching had been that it should be treated with CABG.

In Circulation, published online, is support for this:

Outcomes in Patients With De Novo Left Main Disease Treated With Either Percutaneous Coronary Intervention Using Paclitaxel-Eluting Stents or Coronary Artery Bypass Graft Treatment in the Synergy Between Percutaneous Coronary Intervention With TAXUS and Cardiac Surgery (SYNTAX) Trial @ http://goo.gl/UNAV

Patients with LM disease who had revascularization with PCI had safety and efficacy outcomes comparable to CABG at 1 year; longer follow-up is required to determine whether these 2 revascularization strategies offer comparable medium-term outcomes in this group of complex patients.

Of course, the case we commented upon (ACS during CEA with CPR) represented a true emergency.

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