Intravascular imaging for left main stem assessment: An update on the most recent clinical data

Catheter Cardiovasc Interv. 2022 Dec;100(7):1220-1228. doi: 10.1002/ccd.30440. Epub 2022 Oct 23.


Left main (LM) stem has different structural and anatomical characteristics compared to all of the other segments of the coronary tree, thus its management through percutaneous coronary intervention (PCI) is a challenge and is associated with worse clinical outcome and higher need for revascularization as compared to other lesion settings. Intravascular imaging, by means of intravascular ultrasound (IVUS) or optical coherence tomography (OCT), is an important tool for LM PCI guidance, aiming at improving the immediate performance and the long term outcome of this procedure. Following current guidelines and recent scientific findings, IVUS becomes important to firstly assess, and finally evaluate the result of LM stenting, according to the experience and preferences of the operator. The role of OCT still remains to be defined, but recent data is shedding light also on this imaging technique. The aim of this review is to highlight the latest scientific advancements regarding intravascular imaging in LM coronary artery disease.

Keywords: IVUS; OCT.; intravascular imaging; left main disease.

Publication types

  • Review

MeSH terms

  • Coronary Angiography / methods
  • Coronary Artery Disease* / diagnostic imaging
  • Coronary Artery Disease* / pathology
  • Coronary Artery Disease* / therapy
  • Coronary Vessels / diagnostic imaging
  • Coronary Vessels / pathology
  • Humans
  • Percutaneous Coronary Intervention* / adverse effects
  • Percutaneous Coronary Intervention* / methods
  • Tomography, Optical Coherence / methods
  • Treatment Outcome
  • Ultrasonography, Interventional / methods