Webinar 10 | Assessment of Left Main Stenosis-Step-by-Step IVUS and OCT Imaging of LM, Dr. Valeria Paradies

Step-by-Step IVUS and OCT Imaging of LM, Dr. Valeria Paradies

Video Transcription

Video Summary

The presentation discussed the use of intravascular imaging (IVUS and OCT) combined with physiology for assessing and treating left main coronary artery disease, highlighting limitations of angiography alone. Intravascular imaging provides superior lesion evaluation, especially at bifurcations, guiding stent placement and optimization to reduce complications such as stent deformation and side branch occlusion. Key considerations include coaxial catheter positioning, plaque morphology, calcium distribution, and wire positioning to avoid abluminal rewiring. The OCT-guided OCTOBER trial demonstrated that adherence to imaging protocols ensures optimal stent expansion and coverage, leading to low clinical event rates, though some technical errors still impacted outcomes. IVUS and OCT are viewed as complementary modalities, with IVUS favored in complex cases or where contrast use should be minimized. The presenter emphasized a tailored diagnostic and interventional approach based on imaging findings to improve procedural success and patient prognosis in left main interventions.

Keywords

intravascular imaging

left main coronary artery disease

IVUS

OCT

stent optimization