Assessing Patients for Left Main Percutaneous Coronary Intervention – Considerations and Practicalities of Risk Scores

Abstract

Percutaneous coronary intervention for unprotected left main coronary artery (ULMCA) disease has emerged as a reasonable alternative to cardiac surgery in selected patients and, as an essential aspect of contemporary clinical practice, a proper risk stratification is needed in order to assess the most suitable procedure to perform. Besides offering clinicians complementary information that can help guide treatment strategy and providing quality control, procedural risk stratification allows patients to be more adequately informed about the risk/benefit trade-off of the available revascularisation strategy, leading to an informed decision. Several scoring risk models have been proposed, based on clinical and/or angiographic variables, each of which has its limits, thereby restricting the ability to recommend one specific scoring system. This article, providing a brief overview of the major established and evolving contemporary risk models for patients undergoing ULMCA revascularisation, proposes offering clinicians a useful tool in their decision-making process