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The Aging Cardiovascular System: Understanding It at the Cellular and Clinical Levels Correlation between frequency-domain optical coherence tomography and fractional flow reserve in angiographically-intermediate coronary lesions Reappraisal of Reported Genes for Sudden Arrhythmic Death: An Evidence-Based Evaluation of Gene Validity for Brugada Syndrome 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS): Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteries Endorsed Effects of dapagliflozin on major adverse kidney and cardiovascular events in patients with diabetic and non-diabetic chronic kidney disease: a prespecified analysis from the DAPA-CKD trial Optical coherence tomography imaging during percutaneous coronary intervention impacts physician decision-making: ILUMIEN I study Impact of Chronic Total Coronary Occlusion Location on Long-term Survival After Percutaneous Coronary Intervention Interval From Initiation of Prasugrel to Coronary Angiography in Patients With Non–ST-Segment Elevation Myocardial Infarction Effect of Smoking on Outcomes of Primary PCI in Patients With STEMI Hospital Readmission After Perioperative Acute Myocardial Infarction Associated With Noncardiac Surgery

Review Article24 August 2017 Volume 2017:8 Pages 49—59

JOURNAL:Research Reports in Clinical Cardiology Article Link

Intravascular ultrasound-guided percutaneous coronary intervention in left main coronary bifurcation lesions: a review

Sulaiman MJ, Chen SL Keywords: intravascular ultrasound, left main coronary artery, bifurcation, ostial lesion, mid-shaft lesion, crush techniques

ABSTRACT

Drug-eluting stent (DES) intervention is now emerging as an alternative approach for unprotected left main coronary artery (ULMCA) other than coronary artery bypass graft (CABG). Untreated left main (LM) coronary occlusion is always associated with poor prognosis and high mortality rate. Collective data from numerous worldwide registries and results from randomized Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) trial demonstrated that percutaneous coronary intervention (PCI) of ULMCA is a viable alternative in selected patient groups. Intravascular ultrasound (IVUS) provides valuable luminal and plaque details of coronary lesion, which enable precise lesion severity assessment compared to angiographic assessment. IVUS is important to assess intermediate lesion severity, optimizing stent deployment in complex lesions; therefore, reducing poststenting complication has been shown to improve acute procedural result and subsequent clinical outcomes. In the current review, we aimed to focus on the role of IVUS in LM coronary bifurcation lesions.