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Percutaneous Left Atrial Appendage Occlusion for Patients in Atrial Fibrillation Suboptimal for Warfarin Therapy: 5-year Results of the PLAATO (Percutaneous Left Atrial Appendage Transcatheter Occlusion) Study Impact of Transcatheter Mitral Valve Repair on Preprocedural and Postprocedural Hospitalization Rates Rivaroxaban for Thromboprophylaxis in High-Risk Ambulatory Patients With Cancer Prospective Evaluation of Transseptal TMVR for Failed Surgical Bioprostheses: MITRAL Trial Valve-in-Valve Arm 1-Year Outcomes Implications of the local hemodynamic forces on the formation and destabilization of neoatherosclerotic lesions Risk of Cardiovascular Diseases Among Older Breast Cancer Survivors in the United States: A Matched Cohort Study Strain-Guided Management of Potentially Cardiotoxic Cancer Therapy Evolving insights into the role of local shear stress in late stent failure from neoatherosclerosis formation and plaque destabilization Long-Term Outcomes of Patients With Mediastinal Radiation–Associated Coronary Artery Disease Undergoing Coronary Revascularization With Percutaneous Coronary Intervention and Coronary Artery Bypass Grafting Ablation Versus Drug Therapy for Atrial Fibrillation in Heart Failure Results From the CABANA Trial

Review Article2017 May;12(1):8-12.

JOURNAL:Interv Cardiol. Article Link

Use of Intravascular Ultrasound Imaging in Percutaneous Coronary Intervention to Treat Left Main Coronary Artery Disease

De Maria GL, Banning AP. Keywords: Revascularisation; imaging; intravascular ultrasound; left main coronary artery; percutaneous coronary intervention

ABSTRACT


Due to its potential prognostic implications and technical complexity, revascularisation of left main coronary artery (LMCA) disease requires careful consideration. Since publication of the results of the SYNTAX study, and more recently the EXCEL and NOBLE trials, there has been particular interest in percutaneous revascularisation of the LMCA. It is becoming clear that percutaneous revascularisation of LMCA disease requires appropriate lesion preparation and carefully optimised stenting in order to offer patients a treatment option as effective as coronary artery bypass grafting. For this reason intravascular imaging, and especially intravascular ultrasound, is becoming a key procedural step in LMCA percutaneous coronary intervention. In the current review paper we analyse the role of intravascular imaging with intravascular ultrasound in LMCA percutaneous coronary intervention, focusing on the main applications in this context from lesion assessment to stent sizing and optimisation.