One-year follow-up after intravascular ultrasound assessment of moderate left main coronary artery disease in patients with ambiguous angiograms
Andrea S. Abizaid, MDa,
Gary S. Mintz, MD, FACCa,
Alexandre Abizaid, MDa,
Roxana Mehran, MD, FACCa,
Alexandra J. Lansky, MDa,
Augusto D. Pichard, MD, FACCa,
Lowell F. Satler, MD, FACCa,
Hongsheng Wu, PhDa,
Kenneth M. Kent, MD, FACCa and
Martin B. Leon, MD, FACCa
a Intravascular Ultrasound Imaging and Cardiac Catheterization Laboratories, the Washington Hospital Center, Washington, DC, USA
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Figure 1 The correlation between the lesion site MLD by QCA (2.26 ± 0.82 mm) and IVUS (2.81 ± 0.82 mm was r = 0.364, p = 0.0005 [Panel A]). The correlation between the QCA reference diameter (3.91 ± 0.76 mm) and IVUS (4.25 ± 0.78 mm) was r = 0.492, p = 0.0001 (Panel B). IVUS = intravascular ultrasound; MLD = minimum lumen diameter; QCA = quantitative coronary angiography.
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Figure 2 This case example illustrates the discrepancy between angiographic and IVUS evaluation of LMCA disease. This patient underwent bypass surgery for ostial LMCA disease (black arrow). After the bypass grafts closed, he was referred for IVUS study. By QCA, the ostial LMCA stenosis MLD measured 1.32 mm. By IVUS, there was mild diffuse atherosclerosis (white arrows), no significant plaque burden and an MLD of 3.5 mm. LMCA = left main coronary artery. Other abbreviations as in Figure 1.
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Figure 3 The probability of cardiac events at one year was quantitatively related to the IVUS MLD (mm). At the same MLD, the frequency of events was highest in patients with diabetes and at least one untreated vessel with a DS > 50%; intermediate in patients with diabetes or at least one untreated vessel with a DS > 50%, but not both; and lowest in patients with neither diabetes nor an untreated vessel with a DS > 50%. DS = diameter stenosis. All other abbreviations as in Figure 1.
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