Left main coronary artery stenosis: severity evaluation and implications for management.
The significant stenosis of the left main coronary artery is associated with poor outcomes and is considered a strong indication for revascularization. However, deciding whether the stenosis is significant can sometimes be challenging, especially when the degree of stenosis is intermediate, and can necessitate additional tests and imaging modalities. Areas covered: We did a literature search using keywords like 'left main', 'imaging', 'intravascular ultrasound', 'fractional flow reserve', 'computed tomographic angiography' and 'magnetic resonance imaging'. The most commonly used methods for better characterizing intermediate left main coronary stenoses are intravascular ultrasound and fractional flow reserve, while optical coherence tomography is the newer technique that provides better images, but for which not as much data is available. The noninvasive techniques are coronary computed tomographic angiography and, to a lesser degree, coronary magnetic resonance imaging. Expert commentary: Accurately determining the severity of left main coronary stenosis can mean the difference between a major intervention and conservative therapy. The reviewed newer imaging modalities give us greater confidence that patients with left main stenosis are assigned to the right treatment modality.
['Habibi|Susan E|SE|', 'Shah|Rahman|R|', 'Berzingi|Chalak O|CO|', 'Melchior|Ryan|R|', 'Sumption|Kevin F|KF|', 'Jovin|Ion S|IS|']
D000072226:Computed Tomography Angiography D017023:Coronary Angiography D023921:Coronary Stenosis D003331:Coronary Vessels D053805:Fractional Flow Reserve, Myocardial D006801:Humans D012720:Severity of Illness Index D041623:Tomography, Optical Coherence
Left main coronary outcomes intravascular ultrasound fractional flow reserve optical coherence tomography