Left main and multivessel disease

Find all the latest content on left main and multivessel disease published on this website.

The left main coronary artery provides the primary source of blood flow to the left ventricle. Diseases affecting the left main, by itself or in combination with multivessel disease, place the patient at significant risk for life-threatening cardiovascular events. Treatment requires an understanding of all available tools, devices and techniques, like those employed in invasive imaging and functional assessment, as well as taking into account underlying comorbidities such as diabetes. Advances in imaging techniques, as well as the use of adjunctive pharmacotherapy, vascular access or invasive interventions such as bypass surgery, are important, as are understanding bleeding risks. Use the filters below to access PCRonline resources.

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Left main and multivessel disease

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Complex calcified left main bifurcation - LIVE case

05 Oct 2024 – From AICT-AsiaPCR 2024

An 82-year-old woman with diabetes, hypertension, a history of Micra and RCA PCI 2 years later, was admitted for NSTEMI. The coronary angiography showed a very calcified distal left main stenosis, a significant and calcified ostial LAD stenosis (medina: 1 1 0), confirmed by IVUS. She...

Complex calcified left main bifurcation  - LIVE case

Bifurcation PCI with TAP technique - LIVE case

05 Oct 2024 – From AICT-AsiaPCR 2024

A 72-year-old lady with dyslipidemia, hypertension and aspirin intolerance presented an NSTEMI. The coronary angiography showed a distal CX occlusion and a long calcified significant stenosis on proximal LAD with LAD/D3 bifurcation lesion, and a reduced LV function (47%).
Watch the operators as they perform an important...

Bifurcation PCI with TAP technique - LIVE case

Tips and tricks for left main PCI

05 Oct 2024 – From AICT-AsiaPCR 2024

Dive into this comprehensive session to learn essential tips and tricks for tackling left main PCI. Gain insights on managing thrombus at the left main and providing hemodynamic support in low-resource settings. Discover techniques to handle complex lesions at the left main, and learn how to...

Tips and tricks for left main PCI

Complex left main bifurcation PCI - LIVE case

05 Oct 2024 – From AICT-AsiaPCR 2024

Follow this case of a 65-year-old male with hypertension, a smoker with increasing angina. The coronary angiography found ostial calcified LAD and Circonflex confirmed by IVUS, with a preserved LV function.
The operators decided to perform a PCI of the distal left main with the DK-Crush technique...

Complex left main bifurcation PCI - LIVE case

All you need to know on left main bifurcations

04 Oct 2024 – From AICT-AsiaPCR 2024

Explore the latest insights on managing left main bifurcation lesions. Understand the current status of stenting approaches, particularly for left main distal bifurcation lesions. Discover the importance of intravascular imaging guidance in improving clinical outcomes for these complex cases.

All you need to know on left main bifurcations

Optimising outcomes in treating multivessel disease - LIVE case

04 Oct 2024 – From AICT-AsiaPCR 2024

A 75-year-old male with hypertension, dyslipidemia and a lot of co-morbidities presented a positive echo stress test. The coronary angiography showed diffuse calcified disease on LAD, CX, OM1 and RCA. There is significant stenosis on ostial RCA, mid LAD, mid CX and OM1.
After physiology assessment...

Optimising outcomes in treating multivessel disease - LIVE case

How to treat complex calcified lesions

04 Oct 2024 – From AICT-AsiaPCR 2024

Dive into the complex world of treating calcified lesions, where imaging guidance and specialized techniques are crucial. Discover strategies for tackling challenging cases, from calcified left main bifurcations to multivessel disease with severe left ventricular dysfunction. Learn how to leverage imaging insights, calcified modification techniques, and...

How to treat complex calcified lesions

Expert strategies for high-risk left main procedures

04 Oct 2024 – From AICT-AsiaPCR 2024

Expert strategies for high-risk left main procedures

Fighting with calcium is always a struggle

12 Sep 2024

Managing calcified lesions is always a challenge, and while rotablation is the default technique, other methods must sometimes be considered, especially for eruptive calcified nodules, such as Shockwave, OPN balloon, or orbital atherectomy.

Petros Dardas

Author

Petros Dardas
Nikolaos Mezilis

Author

Nikolaos Mezilis
Fight with calcium is always a struggle

Optimal minimal stent area and impact of stent underexpansion in left main up-front 2-stent strategy

10 Jul 2024

The present study aimed to revise the IVUS-derived segmental MSA criteria for optimal stent expansion in patients undergoing an up-front 2-stent strategy using the crush technique for LM bifurcation lesions to predict the 5-year clinical outcomes.

Reviewer

Salvatore Brugaletta
Optimal minimal stent area and impact of stent underexpansion in left main up-front 2-stent strategy