STENTING AS A METHOD OF CHOICE FOR TREATING LEFT MAIN CORONARY ARTERY LESIONS

The aim of this study is to justify the use of stenting as the method of choice for revascularization of left main coronary artery lesions. Materials and methods. A comprehensive analysis of scientific publications and randomized trials was conducted to evaluate the advantages and disadvantages of various stenting techniques for left main coronary artery lesions, to optimize treatment strategies for individual patients, to improve clinical outcomes, to reduce complications, and to enhance the quality of life for patients with left main coronary artery disease. Results. The proper selection of stenting techniques for left main coronary artery lesions is a critical factor for procedural success. The choice of intervention should consider the lesion characteristics of both the main trunk and its side branches. To achieve optimal immediate and long-term outcomes, strict adherence to intervention protocols is essential, particularly in patients requiring the initial use of double-stent techniques. It is worth noting that single-stent techniques may sometimes necessitate a switch to double-stent strategies, with the TAP (T and small protrusion) and Culotte techniques being the most accessible transitions. The single-stent technique remains highly effective for patients with simple anatomical lesions. For simple bifurcation lesions, the “T-stenting” and “TAP” techniques are selectively utilized. Comparative analysis reveals a higher rate of thrombosis with the Culotte technique compared to the DK Crush technique. A critical prerequisite for successful stenting of the left main coronary artery is the use of intravascular imaging, as it ensures precise selection of equipment and reduces the risk of long-term restenosis in the stented segment. Conclusions. The right choice of stenting technique for the left main coronary artery is a key factor in the success of the procedure. Modern technologies and two-stent strategies enable effective treatment of complex lesions, minimizing the risks to the patient.