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血管内超声指导

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Intravascular Ultrasound and Angioscopy Assessment of Coronary Plaque Components in Chronic Totally Occluded Lesions Utility of intravascular ultrasound guidance in patients undergoing percutaneous coronary intervention for type C lesions The impact of intravascular ultrasound guidance during drug eluting stent implantation on angiographic outcomes Coronary plaque redistribution after stent implantation is determined by lipid composition: A NIRS-IVUS analysis Randomized comparison of clinical outcomes between intravascular ultrasound and angiography-guided drug-eluting stent implantation for long coronary artery stenoses Role of intravascular ultrasound in patients with acute myocardial infarction undergoing percutaneous coronary intervention Long-term survival in patients undergoing percutaneous interventions with or without intracoronary pressure wire guidance or intracoronary ultrasonographic imaging: a large cohort study Novel predictors of late lumen enlargement in distal reference segments after successful recanalization of coronary chronic total occlusion Effects of Intravascular Ultrasound-Guided Versus Angiography-Guided New-Generation Drug-Eluting Stent Implantation: Meta-Analysis With Individual Patient-Level Data From 2,345 Randomized Patients IVUS in bifurcation stenting: what have we learned?
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Review Article2015;11 Suppl V:V55-8.

JOURNAL：EuroIntervention. Article Link

IVUS in bifurcation stenting: what have we learned?

Legutko J, Yamawaki M, Costa RA et al. Keywords: intravascular ultrasound; stents; imaging; left main coronary artery; coronary bifurcation lesions

ABSTRACT

Coronary angiography is unable to visualise the atherosclerotic involvement of the arterial wall. Bifurcation lesions are particularly difficult to assess by angiography because overlapping mother and daughter vessels often obscure the lesion and carina. On the contrary, IVUS imaging allows for precise, real-time, cross-sectional assessment of all bifurcation lesion segments, enabling measurements of luminal and vessel areas. Moreover, IVUS evaluation of stent expansion, apposition and edge problems is also superior to angiographic assessment. In spite of the lack of adequately powered randomised trials, there is growing evidence from large registries and meta-analyses showing better acute and long-term outcomes of DES implantation guided by IVUS, in comparison to angiography-guided procedures. In this review, we summarise current scientific evidence, the European Society of Cardiology recommendations and the European Bifurcation Club consensus for the use of IVUS in bifurcation stenting.

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