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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How to manage a calcified LM bifurcation?

05 Apr 2022

Find out more about an 87-year-old male patient with PCI mid-LAD with BMS 9/1998, several risk factors, preserved LVEF and eGFR, symptomatic with unstable angina, and on medical therapy...

Konstantinos Bermpeis

Author

Konstantinos Bermpeis
Marta Belmonte

Author

Marta Belmonte
Prof. Emanuele BARBATO

Author

Emanuele Barbato
How to manage a calcified LM bifurcation?

Sex differences in outcomes after percutaneous coronary intervention or coronary artery bypass graft for left main disease: from the DELTA registries

07 Mar 2022

The DELTA registry data provides real-world observational evidence that confirms what was reported in randomized trials: a higher rate of co-morbidities in women and better intermediate-term outcomes with CABG. 

Dr. Mirvat Alasnag

Reviewer

Mirvat Alasnag
Sex differences in outcomes after percutaneous coronary intervention or coronary artery bypass graft for left main disease: from the DELTA registries

Geographical variations in left main coronary artery revascularisation: a prespecified analysis of the EXCEL trial

14 Feb 2022

The purpose of the prespecified subanalysis of the EXCEL (Evaluation of XIENCE versus Coronary artery bypass surgery for Effectiveness of Left main revascularization) trial was to determine whether the outcomes remained consistent regardless of geography.

Dr. Mirvat Alasnag

Reviewer

Mirvat Alasnag

Reviewer

Ayman Al Saleh
Geographical variations in left main coronary artery revascularisation: a prespecified analysis of the EXCEL trial

One-year outcomes of blinded physiological assessment of residual ischemia after successful PCI - DEFINE PCI trial

10 Feb 2022

The objective of this analysis was to evaluate the impact of residual ischemia detected by post-PCI iFR on clinical outcomes and on residual-angina at the 12-month follow-up of the DEFINE PCI study.

M. Pighi

Reviewer

Michele Pighi
Simone Fezzi

Reviewer

Simone Fezzi
One-year outcomes of blinded physiological assessment of residual ischemia after successful PCI - DEFINE PCI trial

Hybrid step-by-step approach to perform a Robotic DK Crush PCI

28 Jan 2022

View the case of this 65-year-old male patient who was staged for R-PCI of a Medina 1,1,1 distal left main lesion, and discover how the authors used a hybrid robotic and manual approach to perform a DK crush procedure using the second-generation R-PCI device.

Hybrid step-by-step approach to perform a Robotic DK Crush PCI

Defining percutaneous coronary intervention complexity and risk: an analysis of the UK BCIS Database 2006-2016

04 Jan 2022

A multiple logistic regression model was developed to identify variables associated with in-hospital MACCE and to construct a CHIP score. The cumulative effect of this score on patient outcomes was examined.

Reviewer

Salvatore Brugaletta
Defining percutaneous coronary intervention complexity and risk: an analysis of the United Kingdom BCIS Database 2006-2016

Mastering PCI in patients with complex lesions, ACS and HBR

22 Dec 2021 – From GulfPCR-GIM 2021

Watch this video if you wish to learn how to treat patients with complex anatomy, HBR feature, and presenting with ACS, to discuss the latest evidence about DAPT in HBR patients with acute coronary syndrome, and to ask open questions about DAPT for HBR patients. 

Mastering PCI in patients

Challenging STEMI and MVD scenarios

16 Dec 2021 – From GulfPCR-GIM 2021

In this session, five challenging STEMI cases are discussed so as to enable you to find out how to manage complex primary PCI in STEMI with multivessel disease (MVD).

Challenging STEMI and

Left main intervention in 2021

16 Dec 2021 – From GulfPCR-GIM 2021

In this session whose aim is to highlight imaging value, watch the case of a 64-year-old man with diabetes, hypertension and severe interstitial lung disease who presented with new onset of shortness of breath and functional class NYHA II-III for 3 days...

Left main intervention 2021

Technical consideration for left main bifurcation in light of evidence

16 Dec 2021 – From GulfPCR-GIM 2021

Watch this session to get proved that provisional side-branch stenting is recommended for the majority of bifurcation lesions, including the LM, that DK-Crush appears to be the best two-stent technique for important SB with complex stenoses, and that imaging and physiology can optimize stenting strategy decision...

Technical consideration