1 Anatomy.- 1.1 Normal Anatomy: Angle of Take-off.- Course.- Designation of Bifurcation.- Length and Diameter.- 1.2 Coronary Artery Abnormalities.- Pathological Anatomy of the Left Main Coronary Artery: Atheromatous Lesions of the Trunk: Distribution and Localization.- Other Pathological Presentations.- 2 Review of Literature.- 2.1 Data on Surgical Treatment.- 2.2 Data on Angioplasty with Bare Metal Stents in the Unprotected Left Main Coronary Artery.- 2.3 Data on Drug-eluting Stents in the Unprotected Left Main Coronary Artery.- 2.4 Observational Studies on Populations Treated with Drug-eluting stents Only.- 2.5 Observational Studies of Drug-eluting Stents Versus Bare Metal Stents.- 2.6 Non-randomized Studies of Drug-eluting Stents Versus Coronary Artery Bypass Grafting.- 2.7 Randomized Studies of Drug-eluting Stents Versus Coronary Artery Bypass Grafting.- 2.8 Studies on the Prognostic Implications of Stenosis Location.- 2.9 Data on Drug-eluting Stents in Left Main Coronary Artery Trifurcation Lesions.- 2.10 Final Considerations Based on Available Data.- 3 Morpho-functional Assessment of Left Main Coronary Artery Disease.- 3.1 Introduction.- 3.2 The Role of Intravascular Ultrasound.- 3.3 Procedure for Performing Intravascular Ultrasound in the Left Main Coronary Artery.- 3.4 The Role of Fractional Flow Reserve.- 3.5 The Role of Optical Coherence Tomography.- 3.6 Three-dimensional Quantitative Coronary Analysis Reconstruction of the Left Main Coronary Artery.- 3.7 The Role of Multi-slice Computed Tomography.- 3.8 The Role of Cardiovascular Magnetic Resonance.- 4 Left Main Coronary Artery Percutaneous Interventions: Materials and Techniques.- 4.1 Introduction.- 4.2 Materials: Guiding Catheters.- Coronary Wires.- Coronary Balloons.- Coronary Stents.- 4.3 Ostial Lesions: Pitfalls.- Elastic Recoil.- Stent Hang-out.- Ostial Missing.- Sliding.- Proximal–Distal Dissection.- 4.4 Body Lesions: Elastic Recoil.- Difficult Stent Centering.- Sliding.- Proximal–DistalDissection.- 4.5 Distal Lesions: Guiding Catheter.- PCI Wires.- 4.6 Percutaneous Coronary Intervention Technique: Lesion Preparation.- Single Stent Technique.- T-provisional.- Skirt.- Isolated Treatment of LAD and LCX Ostia.- Two-stent Technique.- T-stenting and T-modified Stenting.- Crush and Mini-crush.- Culotte.- 'Reverse' techniques.- V-stenting or V-touching.- Simultaneous Kissing Stents (SKS).- 4.7 Treatment Classification.- A new classification for Left Main Coronary Artery treatment: the 'one-two-three'.- 4.8 Technical Considerations, Pitfalls, Tips, and Tricks.- Crossing Wires.- Size Discrepancy.- Angulated Take-off.- Jailed Wire.- Buddy.- Wire.- Rotablator.- Cutting Balloons.- Recoil.- Thrombus.- Dissection: Anterograde, Retrograde.- 4.9 Intra-aortic Balloon Pump.- 4.10 Specific Anatomical Scenarios.- Left Main Coronary Artery Trifurcation.- Stenosis of Both the Right Coronary Artery and the Left Main Coronary Artery.- Occluded Right Coronary Artery.- Diseased Right Coronary Artery.- 5 Thrombosis and Antiplatelet Therapy
