What question did this study set out to answer?

The aim is to assess the long-term outcomes of IVUS-guided PCI compared to angiography-guided PCI for severely calcified lesions.

March 13, 2026Korean Circulation Journal1 citationsOpen Access

Intravascular Ultrasound-Guided Percutaneous Coronary Intervention for Severely Calcified Lesions Requiring Rotational Atherectomy

DJDuck-Hyun JangSejong General Hospital JKJe Sang KimSejong General Hospital SHSung-Ho Her

Key Points

The aim is to assess the long-term outcomes of IVUS-guided PCI compared to angiography-guided PCI for severely calcified lesions.
Evaluated 511 patients undergoing PCI with rotational atherectomy
Compared outcomes between IVUS-guided and angiography-guided PCI
Analyzed adverse events and optimal stent deployment rates
IVUS-guided PCI reduced cardiac death or myocardial infarction risk (7.0% vs. 11.2%)
Hazard ratio for IVUS effectiveness was 0.41 for the overall population
Optimal stent deployment was achieved in only 25% of patients
Suboptimal results linked to higher rates of adverse events

Abstract

This study evaluated the impact of intravascular ultrasound (IVUS) guidance on long-term outcomes in 511 patients undergoing percutaneous coronary intervention (PCI) with rotational atherectomy for severely calcified lesions.IVUS-guided PCI significantly reduced the risk of cardiac death or myocardial infarction compared with angiography-guided PCI in both the overall population (7.0% vs. 11.2%;hazard ratio HR, 0.41; 95% confidence interval CI, 0.19-0.85;p=0.017) and the inverse probability of treatment weighting-adjusted population (HR, 0.44; 95% CI, 0.23-0.87;p=0.017).Despite IVUS use, optimal stent deployment was achieved in only one-quarter of patients, and suboptimal results were linked to higher adverse events.

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