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Relationship between fractional flow reserve value and the amount of subtended myocardium Predictors of Left Main Coronary Artery Disease in the ISCHEMIA Trial Bosentan therapy in patients with Eisenmenger syndrome: a multicenter, double-blind, randomized, placebo-controlled study Optical coherence tomography and C-reactive protein in risk stratification of acute coronary syndromes High-Resolution Cardiac Magnetic Resonance Imaging Techniques for the Identification of Coronary Microvascular Dysfunction Long-term secondary prevention of cardiovascular disease with a Mediterranean diet and a low-fat diet (CORDIOPREV): a randomised controlled trial Diagnostic Performance of Angiogram-Derived Fractional Flow Reserve: A Pooled Analysis of 5 Prospective Cohort Studies Asia Pacific Consensus Document on Coronary Bifurcation Interventions Fractional Flow Reserve-Guided Multivessel Angioplasty in Myocardial Infarction Angiography Alone Versus Angiography Plus Optical Coherence Tomography to Guide Percutaneous Coronary Intervention Outcomes From the Pan-London PCI Cohort

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.