Can intravascular ultrasound detect left main coronary artery disease accurately?
Paul Schoenhagen
Correspondence Cardiovascular Imaging Center, Department of Diagnostic Radiology and Cardiovascular Medicine, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195, USA
Email schoenp1@ccf.org
This article has no abstract so we have provided the first paragraph of the full text.
Management of atherosclerotic disease of the LMCA remains a clinical challenge, despite improvements in both diagnostic and therapeutic approaches. In patients with angiographically advanced disease, surgical and percutaneous revascularization are established treatment strategies. Further improvements in patient outcomes have been achieved with off-pump bypass surgery1 and drug-eluting stents,2, 3 although the results have not yet been confirmed by large randomized trials. In patients with nonobstructive atherosclerotic LMCA disease, the value of intensive pharmacologic treatment has been documented in consecutive IVUS studies.4 Similar to larger volumetric IVUS studies in unselected coronary artery segments, intensive pharmacologic treatment to achieve an LDL cholesterol level of 1.9 mM/l (75 mg/dl) was associated with arrest of disease progression.5
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