What are the considerations for revascularization of left main CAD?
When considering revascularization of left main CAD, lesion location is an important determinant when considering PCI. Stenting of the left main ostium or trunk is more straightforward than treating distal bifurcation or trifurcation stenoses. In addition, PCI of bifurcation disease is associated with higher restenosis rates than when disease is confined to the ostium or trunk. The ability of the patient to tolerate and comply with DAPT is also an important consideration in revascularization decisions. Use of a Heart Team approach has been recommended in cases in which the choice of revascularization is not straightforward. It is recommended to have routine angiographic follow-up 2 to 6 months after stenting for unprotected left main CAD.