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

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.