Left main and multivessel disease

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.

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...

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.

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.

This case illustrates the challenges of managing a previously bypassed patient in an acute setting with LM disease and high calcium burden involving LAD and Cx ostias, and occlusion of the venous graft towards the Cx. The tortuous anatomy is a further hurdle to management and choice...

Explore left main PCI with intracoronary imaging guidance should be routine, discuss the evidence base for IVUS/OCT guidance, and much more!

Explore evidence on complete revascularisation for patients with STEMI or NSTEMI and multivessel disease, and provide insights into the roles of intracoronary guidance by physiology and imaging.

Additional balloon-based plaque modification after ineffective intravascular lithotripsy of a heavily calcified ostial CX

Poor lesion preparation is an important factor contributing to serious complications in PCI of heavily calcified lesions. We present a case of a stent loss in a left main coronary artery followed by its successful retrieval.