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Review
. 2020 Oct;9(4):419-432.
doi: 10.1016/j.iccl.2020.05.002. Epub 2020 Aug 12.

Percutaneous Coronary Intervention or Surgery for Unprotected Left Main Disease: EXCEL Trial at 5 Years

Lorenzo Azzalini  1 , Gregg W Stone  2
Affiliations
Review

Percutaneous Coronary Intervention or Surgery for Unprotected Left Main Disease: EXCEL Trial at 5 Years

Lorenzo Azzalini et al. Interv Cardiol Clin. 2020 Oct.

Abstract

Although coronary artery bypass graft (CABG) surgery traditionally has been considered the gold standard for left main revascularization, percutaneous coronary intervention has evolved in the past decades so that it now represents a valid alternative to CABG in a large proportion of cases. The landmark Evaluation of XIENCE versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization (EXCEL) trial is the largest contemporary randomized comparison assessing the impact of revascularization strategies for left main disease. This review discusses the background, rationale, design, results, and implications of the EXCEL trial.

Keywords: CABG; Coronary artery bypass graft; Coronary artery disease; EXCEL; Left main; PCI; Percutaneous coronary intervention; Revascularization.

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Conflict of interest statement

Disclosure Dr L. Azzalini has received honoraria from Abbott Vascular, Guerbet, Terumo, and Sahajanand Medical Technologies and research support from ACIST Medical Systems, Guerbet, and Terumo. Dr G.W. Stone has received speaker or other honoraria from Cook, Terumo, QOOL Therapeutics, and Orchestra Biomed; served as a consultant to Valfix, TherOx, Vascular Dynamics, Robocath, HeartFlow, Gore, Ablative Solutions, Miracor, Neovasc, V-Wave, Abiomed, Ancora, MAIA Pharmaceuticals, Vectorious, Reva, and Matrizyme; and received equity/options from Ancora, Qool Therapeutics, Cagent, Applied Therapeutics, Biostar family of funds, SpectraWave, Orchestra Biomed, Aria, Cardiac Success, MedFocus family of funds, and Valfix.

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