title: Extent of atherosclerosis and remodeling of the left main coronary artery determined by intravascular ultrasound.
abstract: This study used intravascular ultrasound (IU) to assess the incidence and extent of left main coronary artery (LMCA) disease and the effects of arterial remodeling. Sixty-nine patients undergoing cardiac catheterization were imaged with a 20 MHz rotational-tip IU device. Nine of the 69 studies (13%) could not be analyzed because of technical (n = 2) or anatomic (n = 7) reasons. Of the remaining 60 patients, 38 (63%) had at least 1 lesion in the left coronary artery perfusion territory by angiography; significant LMCA stenosis was present in 2 patients (3%). Intravascular ultrasonography demonstrated plaques in 27 of 60 LMCAs (45%), 6 of them in patients with normal angiograms. Twenty-four plaques (89%) were eccentric and calcium was present in 4 (15%). The mean minimal lumen diameter was 4.9 +/- 0.8 mm, the maximal lumen diameter was 5.6 +/- 0.8 mm, the planimetered lumen area was 22.6 +/- 6.0 mm2, the plaque area was 3.9 +/- 5.8 mm2, the vessel area was 26.5 +/- 5.9 mm2, and the area stenosis was 13 +/- 19%. In the 27 patients with plaque, plaque area was 8.7 +/- 5.7 mm2 and the area stenosis was 30 +/- 17%. The vessel area was significantly larger in diseased LMCAs (p < 0.001) and correlated with plaque area (r = 0.46). IU examination of the LMCA was feasible in 87% of patients and was more reliable for delineating plaques than angiography.
authors.affiliation: 2nd Medical Clinic, Mainz University, Germany.
authors.forename: T C
authors.initials: TC
authors.lastname: Gerber
authors.forename: R
authors.initials: R
authors.lastname: Erbel
authors.forename: G
authors.initials: G
authors.lastname: Görge
authors.forename: J
authors.initials: J
authors.lastname: Ge
authors.forename: H J
authors.initials: HJ
authors.lastname: Rupprecht
authors.forename: J
authors.initials: J
authors.lastname: Meyer
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014463:Ultrasonography / Q000379:methods