Percutaneous management of patients with acute coronary syndromes from unprotected left main disease: A comprehensive review and presentation of a treatment algorithm

Catheter Cardiovasc Interv. 2016 Jan 1;87(1):90-100. doi: 10.1002/ccd.26034. Epub 2015 Jun 29.

Abstract

The patient with acute coronary syndrome, particularly with myocardial infarction, from an unprotected left main coronary stenosis represents one of the highest risk subgroups with mortality exceeding 25-50%. Once a patient develops cardiogenic shock, the risk of death during index hospitalization is exceedingly high. Percutaneous coronary intervention may improve short- and long-term outcome, particularly if performed prior to shock development. Should the patient survive index hospitalization, survival tends to be rather good. This review summarizes current knowledge and proposes a clinical algorithm for evaluation and treatment. © 2015 Wiley Periodicals, Inc.

Keywords: acute coronary syndrome; cardiogenic shock; myocardial infarction; percutaneous coronary intervention; unprotected left main disease.

Publication types

  • Review

MeSH terms

  • Acute Coronary Syndrome / diagnosis
  • Acute Coronary Syndrome / surgery*
  • Algorithms*
  • Coronary Angiography
  • Coronary Vessels / diagnostic imaging
  • Coronary Vessels / surgery*
  • Humans
  • Percutaneous Coronary Intervention / methods*