Key result
Intravascular imaging methods such as intravascular ultrasonography and optical coherence tomography optimize percutaneous coronary interventions in patients with left main coronary bifurcation lesions.
Why the study?
Left main coronary bifurcation lesions are challenging to assess by angiography with high complication risks, leaving contentious issues regarding how intravascular imaging best optimizes percutaneous coronary interventions.
Does intravascular imaging-guided percutaneous coronary intervention improve outcomes in patients with left main coronary bifurcation lesions compared to angiography-guided intervention?
Does intravascular imaging-guided percutaneous coronary intervention improve outcomes in patients with left main coronary bifurcation lesions compared to angiography-guided intervention?
Intravascular imaging and physiological assessment optimize PCI for left main coronary bifurcation lesions, significantly reducing cardiovascular complications and mortality, though further research is needed for specific lesion types and post-PCI assessment.
Supports imaging guidance for left main bifurcation PCI; leaves open lesion-specific protocols and post-PCI assessment.
The number of interventions for left main coronary bifurcation lesions in the Russian Federation increase annually. Such lesions are among the most challenging cases for endovascular treatment due to a high risk of cardiovascular complications. They are difficult to assess by angiography, and surgeons frequently encounter difficulties during interventions. To avoid complications and improve long-term outcomes, it is crucial to accurately determine the appropriateness of an intervention, assess characteristics of the lesion, and choose the most effective treatment strategy, and intravascular imaging methods, such as fractional flow reserve measurement, intravascular ultrasonography, and optical coherence tomography, can assist in doing so. Recent research demonstrates the effectiveness of these imaging methods at each stage of surgery; however, several contentious and debatable issues that warrant attention and further investigation remain. This article reviews the latest research regarding the use of intravascular imaging to optimize percutaneous coronary interventions in patients with left main coronary bifurcation lesions, as well as to highlight unresolved issues that require further exploration.
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Loginova et al. (2025) conducted a review in Left main coronary bifurcation lesions. Intravascular imaging (IVUS, OCT) and fractional flow reserve (FFR) vs. Angiography-guided PCI was evaluated. Intravascular imaging methods such as intravascular ultrasonography and optical coherence tomography optimize percutaneous coronary interventions in patients with left main coronary bifurcation lesions.
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