Long‐term health outcome and mortality evaluation after invasive coronary treatment using drug eluting stents with or without the IVUS guidance. Randomized control trial. HOME DES IVUS

Structured PICO

Does IVUS guidance during DES implantation improve long-term health outcomes and mortality in patients undergoing invasive coronary treatment?

Population

Patients undergoing invasive coronary treatment using drug eluting stents

Intervention

IVUS guidance during DES implantation

Comparator

Standard high-pressure postdilatation

Outcome

Long-term health outcome and mortalityhard clinical

IVUS guidance during DES implantation did not show superiority over standard high-pressure postdilatation for long-term outcomes, though significant risks of stent thrombosis after DAPT discontinuation were noted.

Abstract

In our randomized trial we failed to demonstrate the superiority of the IVUS guidance during DES implantation over standard high-pressure postdilatation. However we confirmed worrisome results concerning DES thrombosis after discontinuation of dual antiplatelet-treatment with documented stent thrombosis related events in almost 5% of patients with 50% of mortality in this high-risk clinical scenario.

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