PURPOSE: The purpose of the current study was to determine whether there is any incremental benefit to routine intravascular ultrasound (IVUS) guidance of percutaneous coronary intervention. METHODS AND RESULTS: We compared the outcome of 796 patients who underwent an IVUS study (IVUS group) during the index stent procedure with 8274 patients who did not have an IVUS study (angiography group). The primary end point was the composite end point of death, myocardial infarction, or ischemia-driven target vessel revascularization within 9 months of the index stent procedure. There were statistically significant differences in multiple procedural characteristics. Most importantly, those patients who underwent an IVUS study had a larger postprocedural minimal lumen diameter and smaller postprocedural percent diameter stenosis. However, there was no significant difference between the IVUS group and the angiography group with respect to the primary end point (RR 1.10, 95% CI 0.91, 1.32) or any of the individual clinical end points. Adjustment for multiple clinical and procedural characteristics did not significantly alter these findings. CONCLUSIONS: These data suggest that the routine performance of IVUS during stent placement influences the performance of the procedure, as judged by differences in procedural characteristics, but does not improve clinical outcome at 9 months.
RCT Entities:
PURPOSE: The purpose of the current study was to determine whether there is any incremental benefit to routine intravascular ultrasound (IVUS) guidance of percutaneous coronary intervention. METHODS AND RESULTS: We compared the outcome of 796 patients who underwent an IVUS study (IVUS group) during the index stent procedure with 8274 patients who did not have an IVUS study (angiography group). The primary end point was the composite end point of death, myocardial infarction, or ischemia-driven target vessel revascularization within 9 months of the index stent procedure. There were statistically significant differences in multiple procedural characteristics. Most importantly, those patients who underwent an IVUS study had a larger postprocedural minimal lumen diameter and smaller postprocedural percent diameter stenosis. However, there was no significant difference between the IVUS group and the angiography group with respect to the primary end point (RR 1.10, 95% CI 0.91, 1.32) or any of the individual clinical end points. Adjustment for multiple clinical and procedural characteristics did not significantly alter these findings. CONCLUSIONS: These data suggest that the routine performance of IVUS during stent placement influences the performance of the procedure, as judged by differences in procedural characteristics, but does not improve clinical outcome at 9 months.
Authors: José Albuquerque de Figueiredo Neto; Iara Antonia Lustosa Nogueira; Mabel Fernandes Figueiro; Anna Maria Buehler; Otavio Berwanger Journal: Arq Bras Cardiol Date: 2013-07-02 Impact factor: 2.000
Authors: Julie M Miller; Marc Dewey; Andrea L Vavere; Carlos E Rochitte; Hiroyuki Niinuma; Armin Arbab-Zadeh; Narinder Paul; John Hoe; Albert de Roos; Kunihiro Yoshioka; Pedro A Lemos; David E Bush; Albert C Lardo; John Texter; Jeffery Brinker; Christopher Cox; Melvin E Clouse; João A C Lima Journal: Eur Radiol Date: 2008-11-08 Impact factor: 5.315
Authors: Lucas Lodi-Junqueira; Marcos Roberto de Sousa; Leonardo Carvalho da Paixão; Silvana Márcia Bruschi Kelles; Carlos Faria Santos Amaral; Antonio L Ribeiro Journal: Syst Rev Date: 2012-09-21