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Updated: Aug 24, 2025

In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
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Intravascular imaging for left main stem assessment: An update on the most recent clinical data

Bernardo Cortese1, Davide Piraino2, Domitilla Gentile1

  • 1Cardiovascular Research Group, Fondazione Ricerca e Innovazione Cardiovascolare, Milano, Italy.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|October 23, 2022
PubMed

Insights

Intravascular imaging, such as intravascular ultrasound (IVUS), aids in guiding percutaneous coronary intervention (PCI) for challenging left main (LM) stem lesions. This review highlights advancements in imaging for better LM coronary artery disease outcomes.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Imaging

Background:

  • Left main (LM) stem lesions present unique challenges in percutaneous coronary intervention (PCI) due to distinct anatomical characteristics.
  • PCI for LM stem lesions is associated with poorer clinical outcomes and increased revascularization rates compared to other coronary segments.

Purpose of the Study:

  • To review the latest advancements in intravascular imaging techniques for managing left main coronary artery disease.
  • To emphasize the role of intravascular imaging in guiding and evaluating LM PCI procedures.

Main Methods:

  • Review of current guidelines and recent scientific literature on intravascular imaging in LM PCI.
  • Focus on intravascular ultrasound (IVUS) and optical coherence tomography (OCT) applications.

Main Results:

  • Intravascular ultrasound (IVUS) is crucial for assessing and evaluating LM stenting results, aligning with operator experience and preferences.
  • Emerging data suggests a defined role for optical coherence tomography (OCT) in LM PCI, though its utility is still under investigation.

Conclusions:

  • Intravascular imaging is a vital tool for optimizing LM PCI performance and long-term patient outcomes.
  • Continued research and data on OCT will further refine its application in LM coronary artery disease management.

Keywords:
IVUSOCT.intravascular imagingleft main disease

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