Background: Diameter stenosis of more than 50% within the stent or at its margins (five-millimeter segments next to the stent) on coronary angiography is commonly and arbitrarily used to define in-stent restenosis (ISR). Aim and objectives: The aim of this study was to compare the short-term outcomes of IVUS-guided management of patients with In-Stent restenosis with angiography-guided management. Patients and methods: Following authorization from our institution's ethical board, 60 patients undergoing revascularization at Al-Azhar University Hospital for ISR participated in this observational cohort study comparing outcomes from February 2023 to November 2024. Results: Compared to the angiography group, the IVUS group required much more time for the procedure and fluoroscopy. When comparing the IVUS and angiography groups, the contrast volume was noticeably lower in the former. While 3 patients (10%) in the angiography group and 1 patient (3.33%) in the IVUS group experienced restenosis, there was no statistically significant difference between the two groups. Conclusion: IVUS-guided interventions were associated with significantly reduced contrast volume and lower post-NC balloon dilatation requirements; however, they had longer procedure and fluoroscopy times compared to the angiography intervention. Both methods showed improvements in left ventricular ejection fraction over six months, indicating beneficial outcomes with both approaches.
Aref et al. (Sat,) studied this question.