What are the considerations for revascularization when treating left main CAD?
When treating left main CAD, several considerations must be taken into account when determining the best revascularization strategy. Lesion location is an important factor when considering PCI for unprotected left main CAD, as stenting of the left main ostium or trunk is generally less complex than treating distal bifurcation or trifurcation stenoses. Additionally, the operative risk of CABG can be estimated using a standard instrument, such as the risk calculator from the STS database. The ability of the patient to tolerate and comply with dual antiplatelet therapy is also an important consideration. Finally, the 2005 PCI guidelines recommend routine angiographic follow-up 2 to 6 months after stenting for unprotected left main CAD.