Does OCT Optimise Results of Stenting on the Left Main Stem

Prior treatment

• Contraindication to dual antiplatelet therapy for at least 6 (or 12) months (duration depending on the initial clinical presentation). Shorter dual antiplatelet therapy is possible in patients with long-term anticoagulation.

Other illness

• ST segment elevation myocardial infarction
• Unstable ventricular arrhythmia
• Hypersensitivity or contraindication to any of the antithrombotic therapies used during or after the procedure
• Failure to provide written informed consent

Lab values

• Creatinine clearance ≤ 30 ml/min/1.73m²
• Left ventricular ejection fraction \<30%

Other

• Patients with:
• Ostial lesion of the left main stem
• Technically impossible to perform OCT
• Hypotension or cardiogenic shock
• Life expectancy \<1 year
• Persons under judicial protection
• Subjects with no social security coverage
• Anticipated non-compliance with the study procedures
• Pregnant or lactating women
• Subjects within the exclusion period of another clinical trial

• Patients aged 18 years or over presenting with:
• NSTEMI or unstable angina or stable angina or documented silent ischemia AND
• De novo angiographic lesion (% diameter stenosis \>=50%) or functionally significant (FFR\<=0.80) lesion of the left main stem (median or distal) with or without lesions of the ostia of the LAD and/or circumflex arteries (= Medina classification 1-0-0, 1-0-1, 1-1-0, 1-1-1) or ostial lesion of the LAD and/or circumflex artery requiring angioplasty with stent implantation that will cover the distal left main stem (=Medina classification 0-0-1, 0-1-0 ou 0-1-1) AND
• SYNTAX score ≤ 22 (or \>22 and ≤32 and validated by the Heart Team)
• Lesion with reference angiographic diameter \<=5.5mm
• Signature of written informed consent form.