Left Main Coronary Artery Percutaneous Interventions: Materials and Techniques

Abstract

Before discussing this topic in more detail, a series of general considerations needs to be made:

• not all LMCA lesions should be treated with PCI

• LMCA lesions can be easily treated without major concerns in experienced centers by skilled and experienced operators

• the success of LMCA PCI depends on the availability of material and devices and the use of an appropriate technique

• in all LMCA lesions, pre-dilatation provides sufficient blood flow inside the main left coronary artery

• on the other hand, a tight lesion allows a stable stent positioning, especially at an ostial or shaft location

• when treating bifurcations, temporary occlusion of the LMCA, LAD, and LCX during use of a kissing balloon does not jeopardize the procedure

• the learning curve is crucial in choosing the best option for each case, after guiding catheter positioning.