Key result
IVUS-guided PCI may reduce long-term mortality and stent thrombosis versus angiography, especially with DES.
Why the study?
Optimization of stent deployment under IVUS guidance may be clinically important due to increased incidence of suboptimal stent results and risks after DES use in high-risk lesion subsets.
Does intravascular ultrasound (IVUS) guidance improve stent deployment optimization and clinical benefits during percutaneous coronary intervention?
Does intravascular ultrasound (IVUS) guidance improve stent deployment optimization and clinical benefits during percutaneous coronary intervention?
Intravascular ultrasound (IVUS) guidance may be clinically important for optimizing drug-eluting stent deployment and mitigating the risk of suboptimal results such as stent underexpansion and thrombosis.
May support selective IVUS use in DES PCI; leaves open confirmation by large randomized trials.
Intravascular ultrasound (IVUS) is a useful diagnostic method that provides valuable information in addition to angiography regarding the coronary vessel lumen, dimensions, plaque burden, and characteristics. The major use of IVUS in coronary intervention is to guide interventional strategies and assess optimal stent deployment. Since the introduction of the drug-eluting stent (DES), concerns about restenosis have decreased. However, high-risk lesion subsets are being routinely treated with DESs, and the incidence of suboptimal results after stent deployment, such as stent underexpansion, incomplete stent apposition, edge dissection, geographic miss, and the risk of stent thrombosis, have correspondingly increased. Thus, optimization of stent deployment under IVUS guidance may be clinically important. In this review, we focus on the potential role of IVUS in stent optimization during percutaneous coronary intervention and its clinical benefits.
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Yoon et al. (2012) conducted a review in Coronary artery disease requiring percutaneous coronary intervention. Intravascular ultrasound (IVUS)-guided percutaneous coronary intervention vs. Angiography-guided percutaneous coronary intervention was evaluated. Intravascular ultrasound-guided percutaneous coronary intervention may reduce long-term mortality and stent thrombosis compared with angiography-guided intervention, particularly after drug-eluting stent implantation.
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