Is it time for elective left main percutaneous coronary inter-vention to become 'main stream'?

Left main (LM) stenting is considered by many to be one of the last frontiers of interventional cardiology. Begin-ning with the VA cooperative study published in 1976 demon-strating a mortality benefit for patients undergoing coronary artery bypass grafting (CABG), ' the standard of care for treat-ment of left main coronary artery disease has been surgical. The most recent 2005 update of the ACC/AHA/SCAI Practice Guidelines on PCI2 again notes that "CABG using IMA graft-ing is the 'gold standard' for treatment of unprotected left main disease and has proven benefit on long-term outcomes."