Impact of Intravascular Ultrasound Utilization for Stent Optimization on 1-Year Outcomes After Chronic Total Occlusion Percutaneous Coronary Intervention. Academic Article uri icon

Overview

abstract

  • BACKGROUND: The impact of intravascular ultrasound (IVUS) utilization for stent optimization on the long-term outcomes in chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. METHODS: We examined the outcomes of CTO-PCI with and without IVUS use for stent optimization in 922 CTO-PCIs performed between 2012 and 2019 at 12 United States centers. Major adverse cardiac event (MACE) was defined as the composite of cardiac death, acute coronary syndrome, and target-vessel revascularization. RESULTS: IVUS was used in 344 procedures (37%) for stent optimization. Mean patient age was 65 ± 10 years and 83% were men. Patients in the IVUS group were less likely to have a prior myocardial infarction (39% vs 50%; P<.01), more likely to undergo right coronary artery CTO-PCI (49% vs 55%; P=.01), and had higher mean J-CTO score (2.6 ± 1.1 vs 2.4 ± 1.2; P=.04). The final crossing strategy in patients in the IVUS group was less likely to be antegrade wire escalation (54% vs 57%) and more likely to be retrograde (29% vs 21%; P<.01). Median follow-up was 141 days (interquartile range, 30-365 days). The incidence of 12-month MACE was similar in the IVUS and no-IVUS groups (20.3% vs 18.3%; log-rank P=.67). CONCLUSION: IVUS was used for stent optimization in approximately one-third of CTO-PCIs. Despite higher lesion complexity in the IVUS group, the incidence of MACE was similar during follow-up.

authors

  • Vemmou, Evangelia
  • Khatri, Jaikirshan
  • Doing, Anthony H
  • Dattilo, Phil
  • Toma, Catalin
  • Sheikh, Abdul
  • Alaswad, Khaldoon
  • Jefferson, Brian K
  • Patel, Taral N
  • Chandwaney, Raj H
  • Jaffer, Farouc A
  • Jaber, Wissam
  • Samady, Habib
  • Gkargkoulas, Fotios
  • Moses, Jeffrey W
  • Lembo, Nicholas J
  • Kirtane, Ajay J
  • Parikh, Manish A
  • Ali, Ziad A
  • Megaly, Michael
  • Omer, Mohamed
  • Nikolakopoulos, Ilias
  • Xenogiannis, Iosif
  • Stanberry, Larissa
  • Garberich, Ross F
  • Rangan, Bavana V
  • Garcia, Santiago
  • Burke, M Nicholas
  • Abdullah, Shuaib
  • Banerjee, Subhash
  • Brilakis, Emmanouil S
  • Karmpaliotis, Dimitri

publication date

  • July 22, 2020

Research

keywords

  • Coronary Occlusion
  • Percutaneous Coronary Intervention

Identity

Scopus Document Identifier

  • 85092681892

PubMed ID

  • 32694224

Additional Document Info

volume

  • 32

issue

  • 10