Left main and multivessel disease

Find all the latest content on left main and multivessel disease published on this website.

The left main coronary artery provides the primary source of blood flow to the left ventricle. Diseases affecting the left main, by itself or in combination with multivessel disease, place the patient at significant risk for life-threatening cardiovascular events. Treatment requires an understanding of all available tools, devices and techniques, like those employed in invasive imaging and functional assessment, as well as taking into account underlying comorbidities such as diabetes. Advances in imaging techniques, as well as the use of adjunctive pharmacotherapy, vascular access or invasive interventions such as bypass surgery, are important, as are understanding bleeding risks. Use the filters below to access PCRonline resources.

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Left main and multivessel disease

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Top cases of AICT-AsiaPCR 2023

21 Sep 2023 – From AICT-AsiaPCR 2023

Discover the most intriguing cases featured at AICT-AsiaPCR 2023 in this session: from adrenaline surges to complex primary PCIs gone haywire, from CHIP protected PCI in AMICS to complex CTO of an anomalous RCA, dive into these real-world cases and gain valuable insights that expand your...

Top cases of AICT-AsiaPCR 2023

Challenges in calcified lesions

21 Sep 2023 – From AICT-AsiaPCR 2023

Explore a variety of challenging cases in this session, from the perplexing uncrossable STEMI to the specialized "Blocked" balloon anchoring technique, the unique challenges of calcified lesions in elderly patients to the debulking of a calcified nodule within the left circumflex ostium through the stent strut,...

Challenges in calcified lesions

Left main interventions: cutting-edge insights

21 Sep 2023 – From AICT-AsiaPCR 2023

Join us in this session on left main interventions and explore the challenges and strategies for left main PCI in complex cases, from minimalist approaches in limited-resource settings to complex procedures like percutaneous transluminal coronary angioplasty with IVUS guidance.

Left main interventions: cutting-edge insights

Revolutionising coronary calcium treatment: unleashing the potential of intravascular lithotripsy

21 Sep 2023 – From AICT-AsiaPCR 2023

Over the last five years, we have learned that there is a new tool for treating calcium, the greatest enemy of interventional cardiology, which can take various forms: intravascular lithotripsy. In this session, look at how to master this technique in different scenarios, from eccentric calcified...

Revolutionising coronary

Shock the rock with more IVL impulses, and get more gain!

20 Sep 2023

How would you treat this 81-year-old male patient with HTN, diabetes, dyslipidemia, peripheral vasculopathy, previous coronary angioplasty and prostatic adenocarcinoma, who was admitted for effort angina and positive stress test?

Author

Flavio Luciano Ribichini
Concetta Mammone

Author

Concetta Mammone
Mattia Lunardi

Author

Mattia Lunardi
Shock the rock with more IVL impulses, and get more gain!

MULTISTARS AMI: Multivessel immediate versus staged revascularization in STEMI

28 Aug 2023

Aaysha Cader interviews Barbara Elisabeth Stahli on the study design and results that she presented during the ESC Congress 2023 in Amsterdam. 

Immediate multivessel PCI was non-inferior to staged multivessel PCI for reducing death and ischemic events in patients with STEMI and multivessel coronary artery disease.

Author

Aaysha Cader
Barbara Stähli

Author

Barbara Stähli
MULTISTARS AMI

FIRE trial: physiology-guided complete PCI in older MI patients

27 Aug 2023

Luis Ortega-Paz interviews Simone Biscaglia and Gianluca Campo about the FIRE trial.
Results showed elderly patients presenting with either STEMI or NSTEMI benefit from complete revascularization, reducing cardiovascular events risk at 1 year compared to culprit lesion-only PCI.

Published simultaneously in the New England Journal of Medicine

Luis Ortega-Paz

Author

Luis Ortega-Paz
Simone Biscaglia

Author

Simone Biscaglia
Gianluca Campo

Author

Gianluca Campo
FIRE trial: physiology-guided complete PCI in older MI patient

Percutaneous coronary intervention vs coronary artery bypass graft surgery for left main disease in patients with and without acute coronary syndromes: a pooled analysis of 4 randomized clinical trials

05 Jul 2023

This patient-level analysis of randomized trials comparing PCI vs CABG for the treatment of low-to-intermediate CAD involving the LM confirms the absence of long-term differences in mortality between revascularization techniques, regardless of the clinical presentation.

Giovanni Occhipinti

Reviewer

Giovanni Occhipinti
Daniele Giacoppo

Reviewer

Daniele Giacoppo
PCI vs CABG surgery for LM disease in patients with and without ACS: a pooled analysis of 4 randomized clinical trials

PCI or CABG for left main coronary artery disease: the SWEDEHEART registry

28 Jun 2023

While the choice between PCI and CABG for LMCA disease continues to be one of the most controversial topics, patient characteristics & comorbidities must be taken into account, as must the external validity of the results of RCTs in the real world, as the SWEDEHEART registry does.

Panagiotis Xaplanteris

Reviewer

Panagiotis Xaplanteris

Reviewer

Leonidas Koliastasis
PCI or CABG for left main coronary artery disease: the SWEDEHEART registry

Die Hard: high-risk PCI in calcified LM and severe LV dysfunction

14 Jun 2023

How would you treat an extremely calcified sub-occluded LM in a 72-year-old man presenting on "dependent stability and sliding on inotropes"(*), refused by surgery?

(*) INTERMACS III to II

Author

Flavio Luciano Ribichini
Gabriele Pesarini

Author

Gabriele Pesarini
Mattia Lunardi

Author

Mattia Lunardi
Die Hard: high-risk PCI in calcified LM and severe LV dysfunction