What does this research mean for the field?

IVUS guidance during PCI identifies a significantly higher requirement for post-stenting balloon dilatation, while CCTA planning leads to greater contrast medium use and longer stent deployment compared to angiography alone. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To compare procedural outcomes and 30-day major adverse cardiac and cerebrovascular events among IVUS-guided, CCTA-planned, and conventional angiography-guided elective percutaneous coronary intervention.

July 1, 2019Ain Shams Medical JournalOpen Access

Ivus Guided Versus Multi-Slice Ct Coronary Angiography Planned Percutaneous Coronary Intervention Compared to the Conventional Coronary Angiography Guided Intervention.

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Elective percutaneous coronary intervention (PCI) (n=90). Intervention: IVUS-guided and CCTA-planned PCI vs. Conventional coronary angiography-guided PCI. Primary outcome: Major adverse cardiac and cerebrovascular events (MACCEs) at 30 days.

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Key result

IVUS-guided PCI links to more post-stenting balloon dilatation, while CCTA involves more contrast and longer stents.

n=90

Why the study?

IVUS and CCTA are tools to guide PCI, but comparative data on procedural outcomes and MACCEs versus conventional angiography guided PCI are limited.

Does IVUS or CCTA guidance improve procedural outcomes and reduce MACCEs compared to conventional angiography in patients undergoing elective PCI?

Population

90 patients undergoing elective PCI, 84.4% male

Comparison

IVUS guided PCI vs CCTA planned PCI vs angiography guided PCI

Design

Prospective single-centre study

Follow-up

30 days

Authors

MIMina IskandarAin Shams University KKKhaled Abdel KaderAl-Azhar University DKDiaa KamalAin Shams University

Discussion

Member takes

Implication

Distinct procedural effects with IVUS and CCTA show no short-term MACCE benefit; leaves open whether imaging guidance improves elective PCI outcomes.

Key Points

To compare procedural outcomes and 30-day major adverse cardiac and cerebrovascular events among IVUS-guided, CCTA-planned, and conventional angiography-guided elective percutaneous coronary intervention.
Prospective, single-center study including 90 patients undergoing elective PCI divided into three arms (n=30 each): IVUS-guided (Group A), CCTA-planned (Group B), and angiography-guided (Group C).
Assessed procedural variables including contrast volume, total stent length, post-dilation balloon utilization, TIMI flow grade, and in-hospital as well as 30-day MACCEs.
Group B (CCTA-planned) utilized significantly higher contrast volumes (161.67 ± 71.97 mL, P=0.042) and required longer stents (23.76 ± 7.47 mm, P=0.008) than the other groups.
Group A (IVUS-guided) had a significantly higher rate of post-stenting balloon dilatation, required in 28 patients (93.34%, P=0.009).
Satisfactory TIMI 3 flow occurred in 94.37% of patients overall, with no in-hospital MACCEs and no significant differences in adverse events across arms at 30 days.

Study Design

Type

Observational (n=90)

Multicenter

Structured PICO

Does IVUS or CCTA guidance improve procedural outcomes and reduce MACCEs compared to conventional angiography in patients undergoing elective PCI?

Population

90 patients (84.4% male) undergoing elective percutaneous coronary intervention, followed for 30 days.

Exposure

Intra-vascular ultrasound (IVUS) guided PCI or coronary computed tomography angiography (CCTA) planned PCI

Comparator

Conventional coronary angiography guided PCI

Outcome

Procedural outcome and major adverse cardiac and cerebrovascular events (MACCEs) during hospital stay and at 30 days follow-upcomposite

CCTA planning for PCI increases contrast use and stent length, while IVUS guidance increases post-stenting balloon dilatation, with no short-term difference in MACCEs compared to conventional angiography.

Cite This Study

Iskandar et al. (2019) conducted an observational in Elective percutaneous coronary intervention (PCI) (n=90). IVUS-guided and CCTA-planned PCI vs. Conventional coronary angiography-guided PCI was evaluated on Major adverse cardiac and cerebrovascular events (MACCEs) at 30 days. IVUS-guided PCI identified a higher need for post-stenting balloon dilatation (93.34%, P=0.009), while CCTA-planned PCI was associated with greater contrast use and longer stents.

synapsesocial.com/papers/6aad0c6a53db47138ced766e https://doi.org/10.21608/asmj.2019.101275

Topics

Percutaneous coronary intervention Chronic total occlusion PCI

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Implication

Distinct procedural effects with IVUS and CCTA show no short-term MACCE benefit; leaves open whether imaging guidance improves elective PCI outcomes.

Ivus Guided Versus Multi-Slice Ct Coronary Angiography Planned Percutaneous Coronary Intervention Compared to the Conventional Coronary Angiography Guided Intervention.

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Topics

Ivus Guided Versus Multi-Slice Ct Coronary Angiography Planned Percutaneous Coronary Intervention Compared to the Conventional Coronary Angiography Guided Intervention.

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider