Clinique Pasteur, Toulouse, France.
Eur Heart J. 2012 Jan;33(1):36-50b. doi: 10.1093/eurheartj/ehr426.
Coronary artery bypass surgery is considered as the gold standard treatment of unprotected left main coronary artery (ULMCA) disease. Over the last 20 years, improvement in stent technology and operators experience explained the increased number of reports on the results of percutaneous coronary interventions (PCIs) for the treatment of left main (LM) coronary artery lesion. The recent data comparing efficacy and safety of PCIs using drug-eluting stent and coronary artery bypass surgery showed comparable results in terms of safety and a lower need for repeat revascularization for coronary artery bypass surgery. Patient selection for both techniques is fundamental and directly impacts the clinical outcome. Further randomized trials must be conducted to precise the indications of both techniques of revascularization in the treatment of LM disease.
冠状动脉旁路移植术被认为是治疗无保护左主干冠状动脉（ULMCA）疾病的金标准治疗方法。在过去的 20 年中，支架技术和术者经验的提高解释了越来越多的经皮冠状动脉介入治疗（PCIs）治疗左主干（LM）冠状动脉病变的结果报告。最近比较药物洗脱支架 PCI 和冠状动脉旁路移植术治疗效果和安全性的研究数据显示，两者在安全性方面的结果相当，而冠状动脉旁路移植术需要再次血运重建的需求较低。两种技术的患者选择都很重要，直接影响临床结果。必须进行进一步的随机试验，以明确这两种血运重建技术在 LM 疾病治疗中的适应证。
