Patients with isolated proximal left anterior descending coronary artery stenosis have a high risk profile. Interventional treatment with coronary bypass surgery with left internal mammary artery or angioplasty plus stenting have demonstrated benefits versus pharmacological treatment. In the article written by our working group we assessed the efficacy and security of stenting in these patients in a long-term follow-up. The implantation success rate was 98.9% and the new revascularizations rate was 12.2%. At 60 months the global survival and the cardiac death-free rates were 94.8% and 98% respectively. Recent studies have shown the superiority of minimally invasive coronary surgery (off-pump surgery) with left internal mammary artery versus stenting with a lower incidence of new revascularizations than stent alone. We think that glycoprotein IIb/IIIa blockers in selected cases and, furthermore, drug eluted stents will probably become the gold standard therapy for proximal left anterior descending disease.