Comparison Between Coronary Angioplasty and Coronary Artery Bypass Surgery for the Treatment of Unprotected Left Main Coronary Artery Stenosis (the Bologna Registry)

Palmerini, Tullio; Marzocchi, Antonío; Marrozzini, Cinzia; Ortolani, Paolo; Saia, Francesco; Savini, Carlo; Reggiani, Maria Letizia Bacchi; Gianstefani, Silvia; Virzì, Santo; Manara, F; Weldeab, Meron Kiros; Marinelli, Giuseppe; Bartolomeo, Roberto Di; Branzi, Angelo

doi:10.1016/j.amjcard.2006.01.070

Cited by 186 publications

(107 citation statements)

References 20 publications

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“…[147][148][149] Several studies comparing CABG to PCI, however, indicated that the advantage of CABG consists primarily of fewer repeat revascularizations. 139,[149][150][151][152][153][154][155] The study by Brener et al 156 indicates no significant mortality difference between PCI and CABG after 3 years of follow-up. Longer-term follow-up is needed.…”

Section: Recommendations For Pci For Unprotected Left Main Coronary Amentioning

confidence: 99%

2009 Focused Updates: ACC/AHA Guidelines for the Management of Patients With ST‐Elevation Myocardial Infarction (Updating the 2004 Guideline and 2007 Focused Update) and ACC/AHA/SCAI Guidelines on Percutaneous Coronary Intervention (Updating the 2005 Guideline and 2007 Focused Update)

Kushner¹,

Hand

Smith³

et al. 2009

Cathet Cardio Intervent

111

101

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Section: Recommendations For Pci For Unprotected Left Main Coronary Amentioning

confidence: 99%

2009 Focused Updates: ACC/AHA Guidelines for the Management of Patients With ST‐Elevation Myocardial Infarction (Updating the 2004 Guideline and 2007 Focused Update) and ACC/AHA/SCAI Guidelines on Percutaneous Coronary Intervention (Updating the 2005 Guideline and 2007 Focused Update)

Kushner¹,

Hand

Smith³

et al. 2009

Cathet Cardio Intervent

111

101

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“…A drug-eluting stent is now applied to an LMT lesion and demonstrates equivalent mortality and complications to CABG. 12,13) The number of stent implantations to an LMT lesion for AMI will increase when the risk of re-stenosis is eliminated and would reduce the mortality of emergent CABG, which was reported as 7.9%-14.2% and 9.8%-19.2% 2,6) in previous large studies. It is reported that a drug-eluting stent reduced the re-intervention rate compared to the bare-metal stent.…”

Section: Discussionmentioning

confidence: 99%

Coronary Artery Bypass Grafting for Acute Myocardial Infarction in Stent ERA

Tamaki

Goto

Hoshino

et al. 2011

ATCS

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Purpose: We evaluated a treatment strategy for acute myocardial infarction (AMI) that percutaneous coronary intervention (PCI) is performed on a culprit lesion unless the culprit is an unprotected left main trunk. Emergent coronary artery bypass grafting (CABG) is done when the culprit is a left main trunk and a mechanical complication exists. Methods: From 1997 to 2008, 22 and 232 patients underwent CABG for AMI and non-AMI, respectively. Of the 22 patients of AMI, PCI was performed in 12 patients and not performed in 10 patients before surgery. We investigated complication, intubation period, in-hospital mortality and hospitalization period. Results: No in-hospital mortality was observed in all 22 AMI patients. There was no difference in in-hospital mortality and complication between the AMI and the non-AMI patients. No significant difference was found in hospital stay, complication, intubation period, in-hospital mortality and hospitalization period between patients who received preceding PCI and not. Conclusions: These results suggest that our treatment strategy is reasonable. Further studies will be warranted to clarify the role of preceding PCI.

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“…10) In this study, IABP was not usually used for hemodynamically-stable patients in the PCI group, even if they had a high risk profile (LM stenosis and multiple vessel disease). The availability of IABP was also low before sending patients for CABG.…”

Section: Discussionmentioning

confidence: 99%

“…[7][8][9] Until now, the risks and benefits of provisional stenting with DES and bypass surgery for LMCA have seldom been compared. [10][11][12] Therefore, this study attempts to clarify these risks and benefits by analyzing the success rate of these procedures performed in our hospital.…”

mentioning

confidence: 99%

Percutaneous Coronary Intervention Versus Coronary Artery Bypass Graft Surgery for the Treatment of Unprotected Left Main Coronary Artery Stenosis In-Hospital and One Year Outcome After Emergent and Elective Treatments

et al. 2008

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SUMMARYThis study attempts to compare the risks and benefits of provisional stenting with drug eluting stents and bypass surgery for left main coronary artery (LMCA) stenosis.Recent improvements in interventional technologies have increased interest in percutaneous treatment of LMCA stenosis. However, application of percutaneous techniques to LMCA has been sporadic and controversial.In-hospital and one year outcomes of coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) cases were compared. From September, 2003 to June, 2005, a total of 59 consecutive patients with de novo unprotected LMCA stenosis were treated with either CABG or PCI. Twenty patients received non-intravascular ultrasound-guided PCI with a stent in the LMCA. Thirty-nine patients underwent CABG.At 30-day follow-up, the major adverse cardiac and cerebrovascular event (MACE) rates of mortality, myocardial infarction, cerebral vascular accident, and target vessel revascularization were 25.6% in the CABG group and 5% in the PCI group (P = 0.054).At one year follow-up, the MACE rates were 33.3% in the CABG group and 5% in the PCI group. One year MACE for the CABG group significantly differed from that of the PCI group (P = 0.015). The odds ratio (OR) of one year MACE-free survival was 0.75 (P < 0.001) in the CABG group versus the PCI group. Further analysis demonstrated there was a significant difference in in-hospital MACE and one year MACE between the elective CABG group and elective PCI group (P = 0.045). However, there was no significant difference between the emergent CABG group and emergent PCI group (P = 1.000 for in-hospital MACE; P = 0.486 for one year MACE).PCI on unprotected LM offers an alternative option in patients with high surgical risk and appropriate lesion morphology. (Int Heart J 2008; 49: 355-370)

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Comparison Between Coronary Angioplasty and Coronary Artery Bypass Surgery for the Treatment of Unprotected Left Main Coronary Artery Stenosis (the Bologna Registry)

Cited by 186 publications

References 20 publications

2009 Focused Updates: ACC/AHA Guidelines for the Management of Patients With ST‐Elevation Myocardial Infarction (Updating the 2004 Guideline and 2007 Focused Update) and ACC/AHA/SCAI Guidelines on Percutaneous Coronary Intervention (Updating the 2005 Guideline and 2007 Focused Update)

2009 Focused Updates: ACC/AHA Guidelines for the Management of Patients With ST‐Elevation Myocardial Infarction (Updating the 2004 Guideline and 2007 Focused Update) and ACC/AHA/SCAI Guidelines on Percutaneous Coronary Intervention (Updating the 2005 Guideline and 2007 Focused Update)

Coronary Artery Bypass Grafting for Acute Myocardial Infarction in Stent ERA

Percutaneous Coronary Intervention Versus Coronary Artery Bypass Graft Surgery for the Treatment of Unprotected Left Main Coronary Artery Stenosis In-Hospital and One Year Outcome After Emergent and Elective Treatments

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