Left main and multivessel disease

A 51-year-old man with an inferior STEMI and multivessel disease was found to have a thrombotic sub-occlusion in the mid RCA. Angiography also revealed significant disease in the LAD. How would you manage this case?

Mirvat Alasnag provides her take on OPTION-STEMI, presented by Youngkeun Ahn at ESC Congress 2025 in Madrid.

Analyse this case to find out how to successfully manage a patient with a severely calcific left main stenosis and severely reduced ejection fraction.

This case illustrates how a fragile patient with severe three-vessel disease involving LM/LAD was treated. Watch now to find out more, and share your thoughts!

This PCR Textbook outstanding chapter written by F.J. Neumann and colleagues reviews the management of left main coronary disease, comparing PCI and CABG, emphasising patient-specific factors, heart team input, and PCI techniques including imaging and antithrombotic therapy. Available exclusively to subscribers.

This prespecified analysis of the Fractional Flow Reserve versus Angiography for Multivessel Evaluation (FAME 3) trial examined the impact on cardiovascular outcomes of treatment by CABG versus FFR-guided PCI in patients with three vessel disease (3-VD), stratified by acute (NSTEMI) or chronic coronary syndrome (CCS) presentation.

At EuroPCR 2025, Rasha Al-Lamee, Nieves Gonzalo, and Thomas Cuisset highlighted key advances in coronary interventions, with a strong emphasis on managing complex cases—particularly calcified lesions.

Throughout the Course, LIVE cases and expert hotlines showcased dedicated devices and evolving strategies designed specifically for these challenging lesions. Advanced...

This session offers an in-depth analysis of complex left main trifurcation PCI, covering evaluation through imaging and physiology, lesion preparation strategies, and treatment options including stepwise provisional approaches, upfront two-stent techniques, and drug-coated balloons.

An 87-year-old female patient, at high bleeding risk and with preserved LV function, presented 2 months ago with an inferior STEMI and multivessel disease. She initially underwent RCA PCI followed by staged LCx PCI. She was now referred for PCI of a long, heavily calcified lesion...

An 89-year-old male patient presented with stable angina, preserved LV function and some risk factors such as hypertension and diabetes. CT scan and angiography revealed occlusion of proximal RCA and bifurcation lesions on LAD and circumflex (medina 1,1,1). Operators treated the bifurcation lesions with provisional stenting.
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