Revascularization for Unprotected Left Main Stem Coronary Artery Stenosis Journal Articles uri icon

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  • For coronary artery disease with unprotected left main stem (LMS) stenosis, coronary artery bypass grafting (CABG) is traditionally regarded as the "standard of care" because of its well-documented and durable survival advantage. There is now an increasing trend to use drug-eluting stents for LMS stenosis rather than CABG despite very little high-quality data to inform clinical practice. We herein: 1) evaluate the current evidence in support of the use of percutaneous revascularization for unprotected LMS; 2) assess the underlying justification for randomized controlled trials of stenting versus surgery for unprotected LMS; and 3) examine the optimum approach to informed consent. We conclude that CABG should indeed remain the preferred revascularization treatment in good surgical candidates with unprotected LMS stenosis.


  • Taggart, David P
  • Kaul, Sanjay
  • Boden, William E
  • Ferguson, T Bruce
  • Guyton, Robert A
  • Mack, Michael J
  • Sergeant, Paul T
  • Shemin, Richard J
  • Smith, Peter K
  • Yusuf, Salim

publication date

  • March 2008