|2004/2005/2007 Recommendation||2009 PCI Focused Update Recommendations||Comments|
|2005 PCI Guideline, Section 6.3.4.|
|1. It is reasonable that patients undergoing PCI to unprotected left main coronary obstructions be followed up with coronary angiography between 2 and 6 months after PCI. (Level of Evidence: C)||Deleted recommendation (no longer recommended).|
|1. PCI of the left main coronary artery with stents as an alternative to CABG may be considered in patients with anatomic conditions that are associated with a low risk of PCI procedural complications and clinical conditions that predict an increased risk of adverse surgical outcomes (21,138,139).⁎(Level of Evidence: B)||New recommendation|
|2005 PCI Guideline, Section 5.1|
|PCI is not recommended in patients with [. . .] f. Left main disease and eligibility for CABG. (Level of Evidence: C)||Modified recommendation (bullet “f” from Section 5.1and bullet “e” from Sections 5.2. and 5.3. are no longer current; see 2009 Class IIb recommendation #1).|
|2005 PCI Guideline, Sections 5.2, 5.3 PCI is not recommended in patients with [. . .] e. Left main disease and eligibility for CABG. (Level of Evidence: C)|
↵⁎ Stenting for unprotected left main CAD is relatively more favorable for patients with isolated left main coronary artery lesions or left main coronary artery plus single-vessel disease (21), for patients with ostial or mid left main coronary artery lesions (138,140–144), and for patients with factors (such as severe lung disease, prior thoracic surgery, or poor bypass graft targets) that would make CABG a high-risk procedure or unlikely to be successful. Conversely, CABG surgery for unprotected left main CAD may be relatively more favorable for patients with left main CAD plus multivessel disease (21), distal/bifurcation left main coronary artery lesions (138,140–144), or low surgical risk with a good chance of technical success.