title: Intravascular ultrasound-based left main coronary artery assessment: comparison between pullback from left anterior descending and circumflex arteries.
abstract: OBJECTIVE
  We compared continuous pullback from the left anterior descending artery (LAD) with pullback from the circumflex artery (CX) for the assessment of the left main coronary artery (LMCA) by intravascular ultrasound (IVUS).
  
  
  BACKGROUND
  Gray-scale IVUS and virtual histology by IVUS (IVUS-VH) overcome many shortcomings of contrast angiography in diagnostic assessment of the LMCA. IVUS of LCMA can be acquired by continuous pullback from LAD or CX. Equivalence of the two pullback methods has not been investigated.
  
  
  METHODS
  LMCA morphology was assessed by IVUS in 65 patients referred for elective or rescue coronary angiography. In each patient IVUS was performed once using pullback from the LAD and once using pullback from the CX. Intraclass correlation coefficients (ICC) were calculated to measure the degree of reliability.
  
  
  RESULTS
  The mean age of patients was 60.4 +/- 9.5 years (range 40-84). The IVUS-determined degree of stenosis in the LMCA was a mean of 30% +/- 8% (range 15-52%). The ICC showed excellent reliability (ICC > 0.8) for volume measurements within the plaque (lipid volume, fibrolipidic volume, lipid core volume and calcified volume) and for the measurement of large or averaged diameters (maximal vessel diameter, average vessel diameter, average lumen diameter). The ICC was intermediate (ICC 0.5-0.8) for the measurement of small diameters (minimal vessel diameter, minimal lumen diameter, maximal lumen diameter) and for area calculations (minimal lumen area) based on small diameters.
  
  
  CONCLUSIONS
  Overall, there was excellent reliability between IVUS-based LMCA morphology assessment using pullback from either the LAD or the CX.
authors.affiliation: Department of Cardiology, Luzerner Kantonsspital, CH-6000 Luzern 16, Switzerland.
authors.forename: Yves
authors.initials: Y
authors.lastname: Suter
authors.forename: Andreas W
authors.initials: AW
authors.lastname: Schoenenberger
authors.forename: Stefan
authors.initials: S
authors.lastname: Toggweiler
authors.forename: Peiman
authors.initials: P
authors.lastname: Jamshidi
authors.forename: Therese
authors.initials: T
authors.lastname: Resink
authors.forename: Paul
authors.initials: P
authors.lastname: Erne
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D023921:Coronary Stenosis / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D018084:Ultrasonography, Interventional / Q000379:methods*