Cardiovascular Research Group, Fondazione Ricerca e Innovazione Cardiovascolare, Milano, Italy.
Interventional Cardiology Laboratory, Maria Eleonora Hospital, Palermo, Italy.
Catheter Cardiovasc Interv. 2022 Dec;100(7):1220-1228. doi: 10.1002/ccd.30440. Epub 2022 Oct 23.
Left main (LM) stem has different structural and anatomical characteristics compared to all of the other segments of the coronary tree, thus its management through percutaneous coronary intervention (PCI) is a challenge and is associated with worse clinical outcome and higher need for revascularization as compared to other lesion settings. Intravascular imaging, by means of intravascular ultrasound (IVUS) or optical coherence tomography (OCT), is an important tool for LM PCI guidance, aiming at improving the immediate performance and the long term outcome of this procedure. Following current guidelines and recent scientific findings, IVUS becomes important to firstly assess, and finally evaluate the result of LM stenting, according to the experience and preferences of the operator. The role of OCT still remains to be defined, but recent data is shedding light also on this imaging technique. The aim of this review is to highlight the latest scientific advancements regarding intravascular imaging in LM coronary artery disease.
左主干(LM)与冠状动脉树的其他所有节段相比具有不同的结构和解剖学特征,因此通过经皮冠状动脉介入治疗(PCI)来治疗它是一个挑战,与其他病变部位相比,其临床结局更差,需要再血管化的可能性更高。血管内成像,通过血管内超声(IVUS)或光相干断层扫描(OCT),是 LM PCI 指导的重要工具,旨在改善该手术的即时表现和长期结果。根据当前指南和最近的科学发现,IVUS 首先变得很重要,根据操作者的经验和偏好,评估和最终评估 LM 支架置入的结果。OCT 的作用仍有待确定,但最近的数据也揭示了这种成像技术的作用。本综述的目的是强调关于 LM 冠状动脉疾病血管内成像的最新科学进展。