State-of-the-art percutaneous coronary intervention for left main coronary artery disease in Japan.

Autor: Warisawa T; Department of Cardiology, NTT Medical Center Tokyo, Tokyo, Japan., Sonoda S; Department of Cardiovascular Medicine, Saga University, 5-1-1, Nabeshima, Saga, 849-8501, Japan. ssonoda@cc.saga-u.ac.jp., Yamaji K; Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan., Amano T; Department of Cardiology, Aichi Medical University, Aichi, Japan., Kohsaka S; Department of Cardiology, Keio University School of Medicine, Tokyo, Japan., Natsuaki M; Department of Cardiovascular Medicine, Saga University, 5-1-1, Nabeshima, Saga, 849-8501, Japan., Tsujita K; Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan., Hibi K; Department of Cardiology, Yokohama City University Graduate School of Medicine, Yokohama, Japan., Kobayashi Y; Department of Cardiovascular Medicine, Chiba University Graduate School of Medicine, Chiba, Japan., Kozuma K; Department of Cardiology, Teikyo University Hospital, Tokyo, Japan.
Jazyk: angličtina
Zdroj: Cardiovascular intervention and therapeutics [Cardiovasc Interv Ther] 2024 Oct; Vol. 39 (4), pp. 386-402. Date of Electronic Publication: 2024 Jul 30.
DOI: 10.1007/s12928-024-01030-4
Abstrakt: Percutaneous coronary intervention for left main coronary artery disease (LM-PCI) represents a high-risk yet life-saving procedure that has evolved significantly over the years. This review outlines the current state-of-the-art practices for LM-PCI in Japan in detail, emphasizing the integration of coronary physiology and intracoronary imaging alongside with evidence-based standardized technique using latest drug-eluting stents. These advancements enable precise lesion assessment, stent sizing, and optimal deployment, thereby enhancing procedural safety and efficacy. Despite discrepancies between current guidelines favoring coronary artery bypass grafting and real-world practice trends towards increased LM-PCI adoption, particularly in elderly populations with multiple comorbidities, careful patient selection and procedural planning are critical. Future perspectives include further refining LM-PCI through conducting randomized controlled trials integrating advanced techniques and addressing the issue of ostial left circumflex lesions and nationwide standardization of medical care for LM disease.
(© 2024. The Author(s) under exclusive licence to Japanese Association of Cardiovascular Intervention and Therapeutics.)
Databáze: MEDLINE
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