Scientific Letter: Clinical outcome of B2/C type isolated proximal LAD disease treated with drug-eluting stents

The proximal left anterior descending artery (LAD) is a challenging area for percutaneous coronary intervention (PCI) because of concern for injury to the left main artery or occlusion of major side branches (1). Surgical revascularization and percutaneous stent implantation have proven to be safe and efficient strategies in the relief of symptoms. However, even considering the advantages of PCI, such as less invasiveness, immediate procedural success, short hospital stay and quick recovery results of clinical trials comparing the two treatment options directly show that patients undergoing surgical revascularization have significantly less need for reintervention in the long term (2). With the introduction of a new generation of drug-eluting stents (DESs), late angiographic restenosis rates have been consistently clearly lower than those observed with bare-metal stent implantation (3, 4).