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SPECT and PET in ischemic heart failure Cardiovascular biomarkers in patients with acute decompensated heart failure randomized to sacubitril-valsartan or enalapril in the PIONEER-HF trial Mechanical circulatory support devices in advanced heart failure: 2020 and beyond Safety of six-month dual antiplatelet therapy after second-generation drug-eluting stent implantation: OPTIMA-C Randomised Clinical Trial and OCT Substudy Sex Differences in Cardiovascular Pathophysiology: Why Women Are Overrepresented in Heart Failure With Preserved Ejection Fraction Comparison of intravascular ultrasound versus angiography-guided drug-eluting stent implantation: a meta-analysis of one randomised trial and ten observational studies involving 19,619 patients Intravascular ultrasound predictors for edge restenosis after newer generation drug-eluting stent implantation Second-generation drug-eluting stent implantation followed by 6- versus 12-month dual antiplatelet therapy: the SECURITY randomized clinical trial Phenotypic Refinement of Heart Failure in a National Biobank Facilitates Genetic Discovery Intravascular ultrasound-guided vs angiography-guided drug-eluting stent implantation in complex coronary lesions: Meta-analysis of randomized trials

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.