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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Expect trouble when calcium meets tortuous anatomy

01 Aug 2024

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...

Anass Maaroufi

Author

Anass Maaroufi

Author

Sascha Paetzold
Dr. Gabor G. Toth

Author

Gabor G. Toth
Expect trouble when calcium meets tortuous anatomy

Left Main PCI with Intracoronary Imaging Guidance

28 Jun 2024

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

Completeness of revascularisation in acute coronary syndrome patients with multivessel disease

28 Jun 2024

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.

Completeness of revascularisation in acute coronary syndrome patients with multivessel disease

Supplementary super-high pressure balloon-based plaque modification after intravascular lithotripsy

02 Jul 2024

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

Kambis Mashayekhi

Author

Kambis Mashayekhi
Fabiola Costa

Author

Fabiola Costa
Supplementary super-high pressure balloon-based plaque modification after intravascular lithotripsy

Migration of the stent in the left main stem due to poor lesion preparation

23 May 2024

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.

Dr. Krzysztof Pujdak

Author

Krzysztof Pujdak
Migration of the stent in the left main stem due to poor lesion preparation

Mastering the recovery of lost stents in PCI

17 May 2024 – From EuroPCR 2024

This session, comprising selected EuroPCR 2024 Clinical Case submissions, focuses on the management of lost stents during Percutaneous Coronary Intervention (PCI). Participants will explore various cases of stent dislodgement, entrapment, and retrieval challenges, and learn about the corresponding bailout techniques and solutions to preserve coronary flow...

Mastering the recovery of lost stents in PCI

Imaging-guided left main PCI - LIVE case

17 May 2024 – From EuroPCR 2024

A 53-year-old male with a history of advanced malignancy (lung adenoma) and mid LAD PCI last year, along with multiple risk factors (hypertension, dyslipidemia, diabetes, and smoking), presented with angina and a positive stress test and CT. The angiography and CT showed significant left main stenosis...

Imaging-guided left main PCI

Update on coronary physiology in 2024

17 May 2024 – From EuroPCR 2024

This session provides an update on the available options for invasive coronary physiology in 2024. It reviews the latest evidence supporting the clinical adoption of invasive physiology indexes and shares practical tips and tricks for their application. Topics covered include CT-based physiology, pressure wire-based physiology, angiography-based...

Update on coronary physiology in 2024

Scientific highlights, clinical trial updates and key learnings from EuroPCR 2024

17 May 2024 – From EuroPCR 2024

Davide Capodanno presents notable trial updates, coronary devices, and key takeaways from EuroPCR 2024. Highlights include the SOLVE-TAVI and IDEAL-LM trials at 5 years, BIOADAPTOR at 2 years, advancements in drug-coated balloons and DES, as well as insights from REC-CAGEFREE II, LANDMARK, and NOTION-2.

References

  • SOLVE-TAVI: Feistritzer HJ, et al....
EuroPCR 2024 Scientific highlights, clinical trial updates and key learnings

Management of PCI complications - Part 2

17 May 2024 – From EuroPCR 2024

This session focuses on the management of various PCI complications, including iatrogenic dissection after diagnostic coronary angiography, sinus node artery occlusion, a stuck 6F guide in the axillary artery, and the retrieval of a broken balloon. The session features a series of case presentations and discussions,...

Mastering PCI Complications - Part 2