CBS 2019
CBSMD教育中心
中 文

IVUS Guidance

Abstract

Recommended Article

A volumetric intravascular ultrasound comparison of early drug-eluting stent thrombosis versus restenosis IVUS Guidance for Coronary Revascularization: When to Start, When to Stop? American College of Cardiology Clinical Expert Consensus Document on Standards for Acquisition, Measurement and Reporting of Intravascular Ultrasound Studies (IVUS). A report of the American College of Cardiology Task Force on Clinical Expert Consensus Documents First-in-man evaluation of intravascular optical frequency domain imaging (OFDI) of Terumo: a comparison with intravascular ultrasound and quantitative coronary angiography Intravascular ultrasound-guided drug-eluting stent implantation: An updated meta-analysis of randomized control trials and observational studies Temporal Trends in Inpatient Use of Intravascular Imaging Among Patients Undergoing Percutaneous Coronary Intervention in the United States The effect of complete percutaneous revascularisation with and without intravascular ultrasound guidance in the drugeluting stent era A Randomized Study of Distal Filter Protection Versus Conventional Treatment During Percutaneous Coronary Intervention in Patients With Attenuated Plaque Identified by Intravascular Ultrasound

Original Research2010 Jan;5(6):709-15.

JOURNAL:EuroIntervention. Article Link

Diffuse atherosclerotic left main coronary artery disease unmasked by fractal geometric law applied to quantitative coronary angiography: an angiographic and intravascular ultrasound study

Motreff P, Rioufol G, Gilard M et al. Keywords: diffuse atherosclerotic left main coronary artery disease; diffuse atheroma; LMCA; IVUS

ABSTRACT

AIMS - Angiographic analysis of left main coronary artery (LMCA) stenosis can be hindered by the lack of any reference segment when the LMCA is short or there is diffuse atheroma. Fractal geometric law (FGL) enables the theoretic diameter of one bifurcation vessel to be calculated from those of the other two (Dmother=0.678*(Ddaughter1+Ddaughter2). Applied to the LMCA, the FGL can help the quantification of stenoses.


METHODS AND RESULTS - Fifty-two patients with angiographically mild focal LMCA disease (n=14) or normal to nearly normal LMCA (n=38) who had undergone intravascular ultrasound (IVUS) were included. IVUS analysis confirmed all 14 focal stenoses (group C); of the 38 angiographically normal patients, however, 10 were found to present diffuse LMCA disease (group B), the remaining 28 showing a truly healthy LMCA (group A). LMCA stenosis in groups A,B and C was respectively 3%,4% and 42% on usual quantitative coronary angiography(QCA) and 5%, 31% and 43% on QCAfractal applying the FGL. In cases of diffuse atheroma, the FGL corrected the underestimation of LMCA diameter, which averaged 1.2 mm. conclusions: Angiographic underestimation of LMCA stenosis can be corrected by applying the FGL to obtain a theoretic LMCA diameter, thereby unmasking any diffuse atherosclerotic LMCA disease, or to quantify focal stenosis more precisely where the adjacent segments are also pathological.