Benha University

Ahmed Mahmoud Bendary

Asst. Professor

Faculty of Medicine CARDIOLOGY

Intravascular ultrasound-guided percutaneous coronary intervention for patients with unprotected left main coronary artery lesions

Coronary Artery Disease • 2024
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Publication Information
Authors Ahmed Bendary, Ahmed Elsaed, Mohamed Abdelshafy Tabl, et al
Keywords Intravascular Ultrasound, Percutaneous Coronary Intervention, ULMCA, MACE
Journal Coronary Artery Disease
Publisher Wolters Kluwer
Volume Not Available
Issue Not Available
Pages Not Available
publication.type International
Paper Link Open Link
Supplementary Materials Not Available
Abstract
Background
In percutaneous coronary intervention (PCI) procedures for patients with unprotected left main coronary artery (ULMCA) lesions, intravascular ultrasonography (IVUS) guidance has shown potential for enhancing clinical outcomes. However, studies confirming its superiority to conventional angiographic-guided PCI remain few. This study aimed to assess if IVUS-guided PCI for patients with unprotected LMCA stenosis improves clinical outcomes compared to angiographic-guided PCI.

Methods
This randomized clinical study enrolled 181 patients with ULMCA lesions scheduled for drug-eluting stent implantation. Patients were split into 90 in the IVUS-guided group and 91 in the conventional group. Procedural characteristics, clinical outcomes, and the incidence of major adverse cardiovascular event (MACE) were evaluated for all patients. The risk reduction associated with IVUS-guided PCI was evaluated using a multivariate Cox regression analysis.

Results
Patients who underwent IVUS demonstrated significantly higher pre-dilatation before stenting (88.9% vs. 72.5%, P = 0.005), post-dilatation balloon diameter (4.46 ± 0.48 vs. 4.21 ± 0.49, P 
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