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Two-Year Outcomes and Predictors of Target Lesion Revascularization for Non-Left Main Coronary Bifurcation Lesions Following Two-Stent Strategy With 2nd-Generation Drug-Eluting Stents Appropriate Use Criteria and Health Status Outcomes Following Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From the OPEN-CTO Registry Complete Revascularization with Multivessel PCI for Myocardial Infarction Outcome of Applying the ESC 0/1-hour Algorithm in Patients With Suspected Myocardial Infarction Canadian Multicenter Chronic Total Occlusion Registry: Ten-Year Follow-Up Results of Chronic Total Occlusion Revascularization Five-Year Outcomes after PCI or CABG for Left Main Coronary Disease Efficacy and Safety of Stents in ST-Segment Elevation Myocardial Infarction 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society Randomized Comparison Between Radial and Femoral Large-Bore Access for Complex Percutaneous Coronary Intervention Long-Term Prognostic Implications of Previous Silent Myocardial Infarction in Patients Presenting With Acute Myocardial Infarction

Consensus2018 Jul 20;14(4):e467-e474.

JOURNAL:EuroIntervention. Article Link

Intravascular ultrasound in the evaluation and treatment of left main coronary artery disease: a consensus statement from the European Bifurcation Club

Mintz GS, Lefèvre T, Lassen JF et al. Keywords: left main coronary artery stenosis; obstructive LMCA; IVUS; coronary lumen; vessel wall characteristics; LMCA intervention;

ABSTRACT


Interventional cardiology and coronary stent insertion have an increasing role in the optimal management of left main coronary artery (LMCA) stenosis. Assessing the extent of obstructive disease of the LMCA by angiography alone can be challenging. However, in contrast to the two-dimensional, shadow graphic nature of coronary angiography, intravascular ultrasound (IVUS) is an accurate tomographic technique for assessing both the coronary lumen and the vessel wall characteristics. Consequently, it is a particularly useful technique in imaging the LMCA before, during and after intervention. The European Bifurcation Club (EBC) recommends the use of IVUS during most LMCA interventions. The purpose of this consensus document is to review the available IVUS data on LMCA disease evaluation and treatment. It is a practical guide to show "how and when" to use the imaging modality. It is hoped that a standardisation of the practical approach to imaging may allow consolidation of learning and, ultimately, improve patient outcomes.