血管内超声指导 - The Left Main and Coronary Artery Bifurcation Lesion Summit (CBS)

文章摘要

Impact of intravascular ultrasound-guided percutaneous coronary intervention on long-term clinical outcomes in a real world population
Relationship between intravascular ultrasound guidance and clinical outcomes after drug-eluting stents: the assessment of dual antiplatelet therapy with drug-eluting stents (ADAPT-DES) study
First-in-man evaluation of intravascular optical frequency domain imaging (OFDI) of Terumo: a comparison with intravascular ultrasound and quantitative coronary angiography
Clinical impact of intravascular ultrasound-guided chronic total occlusion intervention with zotarolimus-eluting versus biolimus-eluting stent implantation: randomized study
Intravascular ultrasound-guided implantation of drug-eluting stents to improve outcome: a meta-analysis
Assessment of coronary atherosclerosis by IVUS and IVUS-based imaging modalities: progression and regression studies, tissue composition and beyond
Role of Proximal Optimization Technique Guided by Intravascular Ultrasound on Stent Expansion, Stent Symmetry Index, and Side-Branch Hemodynamics in Patients With Coronary Bifurcation Lesions
Intravascular ultrasound guidance to minimize the use of iodine contrast in percutaneous coronary intervention: the MOZART (Minimizing cOntrast utiliZation With IVUS Guidance in coRonary angioplasTy) randomized controlled trial
Mechanical complications of everolimus-eluting stents associated with adverse events: an intravascular ultrasound study
Meta-analysis of outcomes after intravascular ultrasound-guided versus angiography-guided drug-eluting stent implantation in 26,503 patients enrolled in three randomized trials and 14 observational studies

Original Research

2013 Feb;81(3):407-16.

JOURNAL：Catheter Cardiovasc Interv.

Impact of intravascular ultrasound-guided percutaneous coronary intervention on long-term clinical outcomes in a real world population

Hur SH, Kang SJ, Park SJ et al.

7519

Keywords: IVUS guided PCI; angiography-guided PCI; DES; outcome

ABSTRACT

OBJECTIVES - To compare long-term clinical outcomes between intravascular ultrasound (IVUS)-guided and angiography-guided percutaneous coronary intervention (PCI) in a large "real world" registry.

BACKGROUND - The impact of IVUS-guided PCI on clinical outcomes remains unclear.

METHODS - Between January 1998 and February 2006, 8,371 patients who underwent IVUS- (n = 4,627) or angiography- (n = 3,744) guided PCI were consecutively enrolled. Three-year clinical outcomes were compared after adjustment for inverse-probability-of-treatment weighting (IPTW) in the overall population and in separate populations according to stent type.

RESULTS - A crude analysis of the overall population showed that the 3-year mortality rate was significantly lower in the IVUS-guided group than in the angiography-guided group (96.4% ± 0.3% vs. 93.6% ± 0.4%, log-rank P < 0.001). When adjusted by IPTW, patients undergoing IVUS-guided PCI remained at lower risk of mortality (hazard ratio [HR] 0.627; 95% CI 0.50-0.79, P < 0.001). Similarly, in the drug-eluting stent (DES) population, the 3-year risk of mortality was significantly lower in patients undergoing IVUS-guided PCI (HR 0.46; 95% CI 0.33-0.66, P < 0.001). In contrast, IVUS-guided PCI did not reduce the risk of mortality in the bare metal stent population (HR 0.82; 95% CI 0.60-1.10, P = 0.185). However, the risks of myocardial infarction (HR 0.95; 95% CI 0.63-1.44, P = 0.810), target vessel revascularization (HR 1.00; 95% CI 0.86-1.15, P = 0.944), and stent thrombosis (HR 0.82; 95% CI 0.53-1.07, P = 0.109) were not associated with IVUS guidance.

CONCLUSIONS - IVUS-guided PCI may reduce long-term mortality when compared with conventional angiography-guided PCI. This may encourage the routine use of IVUS for PCI in patients undergoing DES implantation. © 2012 Wiley Periodicals, Inc.