Left Main PCI: Mapping the Territory

As the number of ULMCA procedures gradually increases, factors associated with better and worse outcomes are emerging.

Percutaneous coronary intervention (PCI) in unprotected left main coronary arteries (ULMCAs) is a new frontier in interventional cardiology. Recently upgraded guideline recommendations reflect evidence that the procedure can be safe and effective in selected patients (JW Cardiol Dec 14 2011). In this study from the National Cardiovascular Data Registry, investigators examined trends in ULMCA PCI from 2004 through 2008 at 693 centers.

Of 131,004 patients with ≥50% ULMCA stenosis, 5627 (4.3%) underwent PCI. PCI recipients were older (72 vs. 68) and had more comorbidities than non-PCI recipients. Over the 5-year study period, the proportion of patients receiving PCI for ULMCA increased from 3.8% to 4.9%. Most low-urgency patients (82%) received…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI