Left Main Coronary Artery Disease: CABG is superior to PCI

Left main coronary artery disease (LMCAD) is a special part of coronary pathology and its gold standard treatment is coronary artery bypass surgery (CABG). Over the last two decades, the evolution in technology and materials and the growing experience of interventional cardiologist treating acute coronary syndrome improved the results of percutaneous coronary interventions even in patients with LM disease. Recent prospective randomized studies though (SYNTAX) as well as large registries comparing the two methods showed comparable results concerning safety and inferiority of PCI regarding restenosis and need for reintervention. Up to now CABG remains the treatment of choice for LM disease with PCI being a reliable alternative solution in cases of patients of high surgical risk. The above is strongly recommended by the new guidelines.