In this single-site, randomized study, the authors compared the merits of stenting versus minimally invasive bypass surgery the treatment of patients with isolated lesions (>75% diameter stenosis) of the proximal left anterior descending (LAD) coronary artery. Between June 1997 and June 2001, 220 consecutive patients were randomly assigned to treatment – 110 to stenting and 110 to minimally invasive surgery.
The lesion had to be confined to the segment between the origin of the left circumflex coronary artery and the first major septal branch. Patients were excluded if they had acute coronary syndromes requiring immediate intervention, additional clinically significant coronary lesions or valvular heart disease requiring treatment, stenosis of the first diagonal branch or stenosis extending over a major diagonal branch, or if they had previously undergone interventional or surgical treatment for CAD.
Patients with total occlusion and patients with an intramyocardial course of the LAD were also excluded. There were no significant differences between the groups with respect to demographics or base-line variables (including reference diameter) although diabetes was present in 34% of stented patients and only 25% of operated patients.
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