[Current treatment strategy of left main trunk disease--comparison of PCI and CABG]

Drug-eluting stent which was added to our ammunition in 2002 has greatly changed coronary PCI, especially treatment of LMT lesion which had been treated only by CABG. SYNTAX trial recently showed that the outcome of PCI on LMT lesion is equivalent to that of CABG if the lesion is not extended and accompanied by any complication. CABG still shows its superiority in case of patients with diabetes or highly advanced lesion (SYNTAX Score > or = 33). Stenting in bifurcation lesion of LMT is a remaining controversy and development of optimum procedure of such lesion is awaited. As a cardiologist, it is essential to access the option of therapy for each case by consulting with surgeons based on these evidences.