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IVUS Guidance

Abstract

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Intravascular Ultrasound-Guided Versus Angiography-Guided Implantation of Drug-Eluting Stent in All-Comers: The ULTIMATE trial IVUS Guidance Is Associated With Better Outcome in Patients Undergoing Unprotected Left Main Coronary Artery Stenting Compared With Angiography Guidance Alone Intravascular imaging in coronary artery disease Optical coherence tomography is a kid on the block: I would choose intravascular ultrasound Intravascular ultrasound-guided percutaneous coronary intervention in left main coronary bifurcation lesions: a review The Year in Cardiovascular Medicine 2020: Imaging: Looking back on the Year in Cardiovascular Medicine for 2020 in the field of imaging are Fausto Pinto, José Luis Zamorano and Chiara Bucciarelli-Ducci. Judy Ozkan speaks with them Does calcium burden impact culprit lesion morphology and clinical results? An ADAPT-DES IVUS substudy Intravascular ultrasound guidance in drug-eluting stents implantation: a meta-analysis and trial sequential analysis of randomized controlled trials
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Original Research2013 Feb;81(3):407-16.

JOURNAL：Catheter Cardiovasc Interv. Article Link

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. 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.

 

Copyright © 2012 Wiley Periodicals, Inc.


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