Evaluation of Left Main Bifurcation Ostial Area by Main Vessel Intravascular Ultrasound

Assessment of ostium of circumflex artery (Cx) in the main vessel (MV) intravascular ultrasound (IVUS) imaging pullback is prone to measurement error as the scan plane is not perpendicular to the Cx centerline. This study aimed to validate a new automatic approach to assess the side branch (SB) ostium in IVUS pullbacks performed in the MV. A total of 88 pairs of IVUS pullbacks, were performed both in the MV and SB of the left main bifurcation, from 42 patients enrolled in the study. The ostial area of the SB measured in the MV pullback was automatically obtained by a cut-plane analysis. The ostial area of the SB ostium measured in the corresponding SB pullback was used as a reference. The ostial area obtained from the MV pullbacks showed good agreement with the area obtained from the SB pullbacks (r = 0.86, p < 0.001), with an average bias of 0.60 ± 1.22 mm \(^2\) .