Percutaneous coronary intervention of the left main in the elderly: a reasonable option

The management of symptomatic coronary artery disease in older adults presents a conundrum. Depending on their residual life expectancy, treatment is focused more on quality of life and symptomatic relief than on the improvement of long-term prognosis. Consequently, coronary artery bypass grafting (...

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Main Author: Franz-Josef Neumann
Format: Article
Language:English
Published: Permanyer 2025-02-01
Series:REC: Interventional Cardiology (English Ed.)
Online Access:https://recintervcardiol.org/en/index.php?option=com_content&view=article&id=1325
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author Franz-Josef Neumann
author_facet Franz-Josef Neumann
author_sort Franz-Josef Neumann
collection DOAJ
description The management of symptomatic coronary artery disease in older adults presents a conundrum. Depending on their residual life expectancy, treatment is focused more on quality of life and symptomatic relief than on the improvement of long-term prognosis. Consequently, coronary artery bypass grafting (CABG) often is not an option, not only because of an increased and sometimes prohibitive risk but also because of the slow or even incomplete recovery after major surgery in older adults. On the other hand, medical treatment alone is of limited efficacy and may result in polypharmacy, with associated problems of adherence and drug interaction. Thus, percutaneous coronary intervention (PCI) may remain the only reasonable option. Nevertheless, PCI in older adults is often technically challenging and carries a substantially increased risk compared with PCI in younger patients.1 The extent and location of coronary artery disease appear to be even more important in older adults than in younger patients. Specifically, the risk of PCI in older patients is increased by more than twofold, if it involves the left main coronary artery as compared with PCI in other territories.1 Thus, guidance on left main PCI in older adults is particularly needed. There is, however, a paucity of data to aid...
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spelling doaj-art-33c5ebc31e234607aedf591419dd73312025-08-20T02:13:35ZengPermanyerREC: Interventional Cardiology (English Ed.)2604-73222025-02-01711210.24875/RECICE.M24000474Percutaneous coronary intervention of the left main in the elderly: a reasonable optionFranz-Josef Neumann0Department of Cardiology and Angiology, University Heart Center Freiburg · Bad Krozingen, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, GermanyThe management of symptomatic coronary artery disease in older adults presents a conundrum. Depending on their residual life expectancy, treatment is focused more on quality of life and symptomatic relief than on the improvement of long-term prognosis. Consequently, coronary artery bypass grafting (CABG) often is not an option, not only because of an increased and sometimes prohibitive risk but also because of the slow or even incomplete recovery after major surgery in older adults. On the other hand, medical treatment alone is of limited efficacy and may result in polypharmacy, with associated problems of adherence and drug interaction. Thus, percutaneous coronary intervention (PCI) may remain the only reasonable option. Nevertheless, PCI in older adults is often technically challenging and carries a substantially increased risk compared with PCI in younger patients.1 The extent and location of coronary artery disease appear to be even more important in older adults than in younger patients. Specifically, the risk of PCI in older patients is increased by more than twofold, if it involves the left main coronary artery as compared with PCI in other territories.1 Thus, guidance on left main PCI in older adults is particularly needed. There is, however, a paucity of data to aid...https://recintervcardiol.org/en/index.php?option=com_content&view=article&id=1325
spellingShingle Franz-Josef Neumann
Percutaneous coronary intervention of the left main in the elderly: a reasonable option
REC: Interventional Cardiology (English Ed.)
title Percutaneous coronary intervention of the left main in the elderly: a reasonable option
title_full Percutaneous coronary intervention of the left main in the elderly: a reasonable option
title_fullStr Percutaneous coronary intervention of the left main in the elderly: a reasonable option
title_full_unstemmed Percutaneous coronary intervention of the left main in the elderly: a reasonable option
title_short Percutaneous coronary intervention of the left main in the elderly: a reasonable option
title_sort percutaneous coronary intervention of the left main in the elderly a reasonable option
url https://recintervcardiol.org/en/index.php?option=com_content&view=article&id=1325
work_keys_str_mv AT franzjosefneumann percutaneouscoronaryinterventionoftheleftmainintheelderlyareasonableoption