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Prior Balloon Valvuloplasty Versus Direct Transcatheter Aortic Valve Replacement: Results From the DIRECTAVI Trial Aspirin with or without Clopidogrel after Transcatheter Aortic-Valve Implantation Early Surgery or Conservative Care for Asymptomatic Aortic Stenosis Intravascular Ultrasound and Angioscopy Assessment of Coronary Plaque Components in Chronic Totally Occluded Lesions A new strategy for discontinuation of dual antiplatelet therapy: the RESET Trial (REal Safety and Efficacy of 3-month dual antiplatelet Therapy following Endeavor zotarolimus-eluting stent implantation) Effect of Evolocumab on Complex Coronary Disease Requiring Revascularization Transcatheter Aortic Valve Replacement in Low-risk Patients With Bicuspid Aortic Valve Stenosis Identifying coronary artery disease patients at risk for sudden and/or arrhythmic death: remaining limitations of the electrocardiogram Coronary plaque redistribution after stent implantation is determined by lipid composition: A NIRS-IVUS analysis Serial intravascular ultrasound assessment of very late stent thrombosis after sirolimus-eluting stent placement

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.