Revascularization has been demonstrated to be clearly superior to medical therapy for significant unprotected left main coronary artery (LMCA) disease. Coronary artery bypass graft surgery (CABG) has a class 1 indication in both the American and European society guidelines for the treatment of LMCA disease. However, for the population of patients who are declined CABG after a heart team evaluation, percutaneous coronary interventional (PCI) may be an efficacious alternative. This review summarizes the data on percutaneous coronary intervention of distal left main coronary artery disease including the various contemporary techniques and associated challenges.
