dec 16, 2021 by Philips
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Left main disease


Significant left main CAD (greater than 50%) is found in 3-4% of all patients who undergo coronary angiography.1

Left main disease masthead

Clinical challenges
 

  • Left main angiography is highly uncertain2 and can underestimate lesion severity.3
  • Potential dire consequences of stent thrombosis or restenosis.4
  • Left main disease is associated with multi-vessel CAD about 70% of the time.5,6

70% reduction in all-cause mortality out to 3 yrs57

LMD graph

Advanced tools for optimal PCI outcomes

IVUS software image

  • Assists in identifying the plaque distribution, vessel size and help avoid geographic miss of therapy delivery with IVUS Co-registration.
  • Provides better patient outcomes as an IVUS-guided strategy is associated with 70% reduction in all-cause mortality out to 3 years.7

Angio Sculpt Evo RX PTCA scoring balloon catheter

  • Provides the power necessary to maximize lume diameter.
  • Delivers 15-25x’s the focal force of a traditional balloon.8,9,10

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References

 

1. Witzenbichler B et al. Relationship Between Intravascular Ultrasound Guidance and Clinical Outcomes After Drug-Eluting Stents: The ADAPT-DES Study. Circulation 2014 Jan: 129,4;463-470.

2. Lindstaedt M, et al. How good are experienced interventional cardiologists at predicting the functional significance of intermediate or equivocal left main coronary artery stenoses? Int J Cardiol. 2007;120:254-6.

3. Arnett, E. N. et al. Coronary artery narrowing in coronary heart disease: comparison of cineangiographic and necropsy findings. Ann. Intern. Med. 91, 350–356 (1979).

4. Puri R., et al. “Optimizing Outcomes During Left Main Percutaneous Coronary Intervention With Intravascular Ultrasound and Fractional Flow Reserve” JACC Card. Interv. 2012 5(7): 697-707.

5. Taggart DP, Kaul S, Boden WE, et al. Revascularization for unprotected left main stem coronary artery stenosis stenting or surgery. J Am Coll Cardiol 2008; 51:885.

6. Serruys PW, Morice MC, Kappetein AP, et al. Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease. N Engl J Med 2009; 360:961.

7. Park SJ, Kim YH, Park DW, et al. “Impact Of Intravascular Ultrasound Guidance On Long-term Mortality In Stenting For Unprotected Left Main Coronary Artery Stenosis” Circ Cardiovasc Interv. 2009 Jun;2(3):167-77.

8. AngioSculpt Test Report SR-1571 (2008).

9. Costa JR, Mintz GS, Carlier SG, et al. Nonrandomized comparison of coronary stenting under intravascular ultrasound guidance of direct stenting without predilation versus conventional predilation with a semi-compliant balloon versus predilation with a new scoring balloon. Am J Cardiol. 2007;100:812-817.

10. Costa RA, Mooney MR, Teirstein PS, et al. Final results from the multi-center trial of the angiosculpt scoring balloon catheter for the treatment of complex coronary artery lesions Cardiovascular Revascularization Medicine 7 (2006)81–126.

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