Morpho-functional Assessment of Left Main Coronary Artery Disease

Abstract

The morpho-functional assessment of LMCA stenoses plays an essential role both in therapeutic decision making and in the assessment of post-PCI results. While still being considered the gold standard method in the diagnosis of LMCA stenosis, conventional coronary angiography shows all its shortcomings in the quantitative assessment of those lesions, as proven in several studies confirming a high degree of interobserver variability [83–85]. These shortcomings are especially relevant in the case of the LMCA, as the severity of the stenosis correlates with the clinical outcome of patients, and a degree of angiographic stenosis of over 50% is acknowledged as the cut-off for treatment [86]. Moreover, simple angiographic assessment after stent implantation may not ensure a good final result in terms of stent expansion, with the ensuing risk of adverse events such as in-stent thrombosis.