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Use of Intravascular Ultrasound Imaging in Percutaneous Coronary Intervention to Treat Left Main Coronary Artery Disease Attenuated plaque detected by intravascular ultrasound: clinical, angiographic, and morphologic features and post-percutaneous coronary intervention complications in patients with acute coronary syndromes Usefulness of intravascular ultrasound guidance in percutaneous coronary intervention with second-generation drug-eluting stents for chronic total occlusions (from the Multicenter Korean-Chronic Total Occlusion Registry) 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 Intravascular ultrasound-guided implantation of drug-eluting stents to improve outcome: a meta-analysis The role of integrated backscatter intravascular ultrasound in characterizing bare metal and drug-eluting stent restenotic neointima as compared to optical coherence tomography Intravascular ultrasound findings of early stent thrombosis after primary percutaneous intervention in acute myocardial infarction: a Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI) substudy Outcomes with intravascular ultrasound-guided stent implantation: a meta-analysis of randomized trials in the era of drug-eluting stents First-in-man evaluation of intravascular optical frequency domain imaging (OFDI) of Terumo: a comparison with intravascular ultrasound and quantitative coronary angiography Prospective application of pre-defined intravascular ultrasound criteria for assessment of intermediate left main coronary artery lesions results from the multicenter LITRO study
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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.


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