CBS 2019
CBSMD教育中心
中 文

血管内超声指导

Abstract

Recommended Article

3-Year Outcomes of the ULTIMATE Trial Comparing Intravascular Ultrasound Versus Angiography-Guided Drug-Eluting Stent Implantation Intracoronary stenting without anticoagulation accomplished with intravascular ultrasound guidance Combined use of OCT and IVUS in spontaneous coronary artery dissection Clinical Outcomes Following Intravascular Imaging-Guided Versus Coronary Angiography-Guided Percutaneous Coronary Intervention With Stent Implantation: A Systematic Review and Bayesian Network Meta-Analysis of 31 Studies and 17,882 Patients Usefulness of intravascular ultrasound to predict outcomes in short-length lesions treated with drug-eluting stents Long-term outcomes with use of intravascular ultrasound for the treatment of coronary bifurcation lesions Role of intravascular ultrasound in patients with acute myocardial infarction undergoing percutaneous coronary intervention Positive remodeling at 3 year follow up is associated with plaque-free coronary wall segment at baseline: a serial IVUS study

Clinical Trial2010 Mar 1;75(4):578-83.

JOURNAL:Catheter Cardiovasc Interv. Article Link

Long-term health outcome and mortality evaluation after invasive coronary treatment using drug eluting stents with or without the IVUS guidance. Randomized control trial. HOME DES IVUS

Jakabcin J, Spacek R, Bystron M et al. Keywords: IVUS guided PCI; DES; outcome

ABSTRACT


OBJECTIVE - To assess the role of the intravascular ultrasound (IVUS) during implantation of drug-eluting stents (DES) on long-term outcome in patients with complex coronary artery disease and high clinical risk profile with special attention to the development of late stent thrombosis (LST).


METHODS - Two hundred and ten patients were randomly assigned to receive DES either with (N = 105) or without (N = 105) the IVUS guidance. Dual antiplatelet treatment was administered for 6 months in all patients. At 18-month follow-up, the rates of major adverse cardiac events (MACEs) (death, myocardial infarction, and reintervention) were assessed in both groups with special attention to possible LST. Stent thrombosis was classified according to Academic Research Consortium (ARC).


RESULTS - At the 18-month follow-up, there was no significant difference between both groups regarding MACE (11% vs. 12%; P = NS). Stent thrombosis has occurred in four patients (3.8%) in the group with and in 6 patients (5.7%; P = NS) in the group without the IVUS guidance.


CONCLUSIONS - In our randomized trial we failed to demonstrate the superiority of the IVUS guidance during DES implantation over standard high-pressure postdilatation. However we confirmed worrisome results concerning DES thrombosis after discontinuation of dual antiplatelet-treatment with documented stent thrombosis related events in almost 5% of patients with 50% of mortality in this high-risk clinical scenario.