The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)


IVUS guidance during left main PCI: not if, but when and how

EuroIntervention 2020;16:189-191. DOI: 10.4244/EIJV16I3A32

1. Columbia University Medical Center, New York, NY, USA; 2. Cardiovascular Research Foundation, New York, NY, USA; 3. The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA

Compared to angiographic guidance alone, intravascular ultrasound (IVUS) improves clinical outcomes in patients undergoing percutaneous coronary intervention (PCI) because IVUS provides superior information regarding 1) the necessity of adjunctive lesion preparation; 2) optimal device sizing to achieve the largest minimum stent area (MSA), the strongest predictor of future events; 3) appropriate stent length to cover the entire lesion and avoid geographic miss; 4) stent underexpansion or residual disease at the stent edge requiring further treatment; and 5) acute complications including stent edge dissection/haematoma or stent deformation. The benefits of IVUS guidance on clinical outcomes are most pronounced when treating high-risk lesions or patients &...

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