Application Value Of Intravascular Ultrasound In Left Main Coronary Artery Lesion

Objective: The aim is to compare the imaging results of intravascular ultrasound(IVUS) and coronary angiography(CAG)in the left main coronary artery lesion(LMCA),and investigate the application value of intravascular ultrasound in the diagnosis of left main coronary artery lesion.Methods : The study included 151 cases in the Cangzhou Central Hospital,from May 2009 to July 2014(62 female(41.1%),89male(58.9%),mean age 64±16yrs). All the patients with left main coronary artery lesion, were confirmed by coronary angiography and all underwent intravascular ultrasound. Inclusion criteria:1) the patients diagnosed with acute coronary syndrome and stable angina;Patients with obvious angina pectoris;acute coronary syndrome patients included: patients with non ST segment elevation myocardial infarction and patients with unstable angina pectoris(within 1 month of onset or variant angina,worsening exertional angina);2) sinus heart rate.exclusion criteria:1) patients with arrhythmias:Ventricular fibrillation, ventricular tachycardia patients;2) serious liver dysfunction and kidney dysfunction;3) patients were intolerant with iodine contrast medium;4) Left main coronary artery stenosis is very serious, intravascular ultrasound catheter cannot through the lesion;5) patients with the history of coronary artery bypass grafting or left main coronary artery stent implantation. Thispaper respectively compared the result of left main lesion: including the smallest vessel diameter, the diameter stenosis rate,lesion length,was measured by intravascular ultrasound and coronary artery angiography;On the basis of results of intravascular ultrasound coronary artery lesions is divided into calcified plaque, hard plaque and soft plaque;Compared the characteristics of plaque lesions obtained with intravascular ultrasound and coronary angiography.And further compared the plaque eccentricity,whether plaque break.The SPSS 13.0 statistical software was used for data analysis as the statistical analysis,and the difference was statistically significant within P<0.05.Results: Coronary angiography showed minimal lumen diameter in patients with left main lesion(2.29+0.22),the diameter stenosis rate(34.21+8.71) and lesion length(13.12+0.48) and intravascular ultrasound group displayed the minimal lumen diameter(1.93+0.16),the diameter stenosis rate(45.27+8.88) and lesion length(14.43+0.56) were statistically significant(P<0.05).Coronary angiography showed an eccentric lesions,calcification was significantly lower than that of intravascular ultrasound results,and coronary angiography is difficult to display the character of plaque,such as plaque rupture and hard plaque and soft plaque etc.but intravascular ultrasound can display the features of plaque.Conclusion: The results of this study show that coronary angiography may underestimate the extent of left main lesions,and is unable to analyze the features of plaque,while intravascular ultrasound can accurately determine the left main lesion extent,but also can further accurate display of plaque,and has important significance in diagnosis of left main disease.