Percutaneous coronary intervention in left main coronary artery disease: the 13th consensus document from the
Francesco Burzotta1, Jens Flensted Lassen, Adrian P Banning
1Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy.
Insights
This review summarizes the 2017 European Bifurcation Club meeting, focusing on percutaneous coronary intervention (PCI) for left main coronary artery (LM) disease. It covers anatomy, diagnostics, and optimal PCI strategies for improved patient outcomes.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Device Technology
Background:
- Coronary artery disease involving the left main coronary artery (LM) poses significant risks.
- Percutaneous coronary intervention (PCI) is a key treatment modality for LM disease.
- The European Bifurcation Club (EBC) provides a platform for expert consensus and guideline updates.
Purpose of the Study:
- To review and synthesize the latest data on coronary bifurcation interventions, with a focus on LM disease.
- To discuss optimal strategies for PCI in LM disease, including anatomical assessment and procedural techniques.
- To highlight the importance of team organization and catheterization laboratory setup for successful LM PCI.
Main Methods:
- Review of current literature and expert discussions from the 2017 EBC meeting.
- Analysis of key anatomical features, diagnostic modalities, and clinical outcome data relevant to LM PCI.
- Critical evaluation of catheterization laboratory setup, device selection, and implantation techniques.
Main Results:
- Key anatomical considerations and diagnostic approaches for LM disease were reviewed.
- Optimal lesion preparation, drug-eluting stent (DES) implantation techniques, and strategies for unprotected LM PCI were discussed.
- The impact of PCI team organization and performance on clinical outcomes was emphasized.
Conclusions:
- Optimal management of LM disease requires a multidisciplinary approach and careful consideration of procedural details.
- Evidence-based strategies for PCI in LM disease are evolving, emphasizing patient selection and technique.
- Adherence to best practices in LM PCI is crucial for achieving favorable patient outcomes.
Abstract:
The 2017 European Bifurcation Club (EBC) meeting was held in Porto (Portugal) and allowed a multidisciplinary international faculty to review and discuss the latest data collected in the field of coronary bifurcation interventions. In particular, the topic of percutaneous coronary intervention (PCI) on left main coronary artery (LM) disease was highlighted as a contemporary priority. Herein, we summarise the key LM anatomy features, the diagnostic modalities and available data that are relevant for a patient's procedural management. Since the clinical outcomes of patients undergoing PCI on LM disease may depend on both PCI team organisation and PCI performance, the optimal catheterisation laboratory set-up and the rationales for device and technique selection are critically reviewed. The best lesion preparation modalities, the different DES implantation technique choices and the strategies to be considered during PCI on unprotected LM for optimal PCI results are reviewed step by step.
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