[Percutaneous coronary interventions on unprotected left main coronary artery: contemporary outlook of the problem]

Coronary bypass surgery in patients with lesions in unprotected left main coronary artery (LMCA) remains gold standard of treatment. However there is a tendency to more frequent use of percutaneous coronary interventions (PCI) in patients with such lesions. Is PCI of LMCA justified, what is complication rate of PCI of LMCA? In order to answer these questions we analyzed modern studies in which PCI with the use of standard metal and drug eluting stents were carried out in patients with lesions in unprotected LMCA. Studies in which PCI was compared with coronary bypass surgery was also reviewed.

Registry data, in which PCI and coronary bypass surgery were compared showed promising results of PCI, but designs of these studies did not allow to make unequivocal conclusion. The authors of considered studies has agreed that for definite reply randomized multicenter trials are required.