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The Comparison of Clinical Outcomes After Drug-Eluting Balloon and Drug-Eluting Stent Use for Left Main Bifurcation In-Stent Restenosis Gut microbiota induces high platelet response in patients with ST segment elevation myocardial infarction after ticagrelor treatment Bench testing and coronary artery bifurcations: a consensus document from the European Bifurcation Club The Relation Between Optical Coherence Tomography-Detected Layered Pattern and Acute Side Branch Occlusion After Provisional Stenting of Coronary Bifurcation Lesions Nicotine promotes vascular calcification via intracellular Ca21-mediated, Nox5-induced oxidative stress, and extracellular vesicle release in vascular smooth muscle cells Patient and Hospital Characteristics of Mitral Valve Surgery in the United States Will Pulmonary Artery Denervation Really Have a Place in the Armamentarium of the Pulmonary Hypertension Specialist? Evolving understanding of the heterogeneous natural history of individual coronary artery plaques and the role of local endothelial shear stress Impact of myocardial supply area on the transstenotic hemodynamics as determined by fractional flow reserve Intravascular optical coherence tomography

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.