Konstantinos C Koskinas1, Masato Nakamura2, Lorenz Räber1, Roisin Colleran3, Kazushige Kadota4, Davide Capodanno5, William Wijns6, Takashi Akasaka7, Marco Valgimigli1, Giulio Guagliumi8, Stephan Windecker1, Robert A Byrne3,9. 1. Department of Cardiology, Bern University Hospital. 2. Toho University, Ohashi Medical Center. 3. Deutsches Herzzentrum München, Technische Universität München. 4. Kurashiki Central Hospital. 5. Ferrarotto Hospital, University of Catania. 6. The Lambe Institute for Translational Medicine and Curam Saolta University Healthcare Group. 7. Wakayama Medical University. 8. Interventional Cardiology Unit, Azienda Ospedaliera Papa Giovanni XXIII. 9. DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance.
Abstract
BACKGROUND: This study evaluated the views of the cardiology community on the clinical use of coronary intravascular imaging (IVI).Methods and Results: A web-based survey was distributed to 31,893 individuals, with 1,105 responses received (3.5% response rate); 1,010 of 1,097 respondents (92.1%) self-reported as interventional cardiologists, 754 (68.7%) with >10 years experience. Overall, 96.1% had personal experience with IVI (95.5% with intravascular ultrasound [IVUS], 69.8% with optical coherence tomography [OCT], and 7.9% with near-infrared spectroscopy); 34.7% of respondents were from Europe and 52.0% were from Asia (45.4% from Japan). The most commonly reported indications for IVI were optimization of stenting (88.5%), procedural/strategy guidance (79.6%), and guidance of left main interventions (77.0%). Most respondents reported perceived equipoise regarding choice between IVUS and OCT for guidance of coronary intervention. High cost (65.9%) and prolongation of the procedure (35.0%) were the most commonly reported factors limiting use. IVI was used more frequently (>15% of cases guided by IVI) in Japan than Europe (96.6% vs. 10.4%, respectively; P<0.001) and by operators with longer interventional experience. CONCLUSIONS: In a sample of predominantly experienced interventional cardiologists, there was a high rate of personal experience with IVI in clinical practice. The most commonly identified indications for IVI were optimization of stenting, procedural/strategy guidance, and guidance of left main interventions. Variability in practice patterns is substantial according to geographic region and interventional experience.
BACKGROUND: This study evaluated the views of the cardiology community on the clinical use of coronary intravascular imaging (IVI).Methods and Results: A web-based survey was distributed to 31,893 individuals, with 1,105 responses received (3.5% response rate); 1,010 of 1,097 respondents (92.1%) self-reported as interventional cardiologists, 754 (68.7%) with >10 years experience. Overall, 96.1% had personal experience with IVI (95.5% with intravascular ultrasound [IVUS], 69.8% with optical coherence tomography [OCT], and 7.9% with near-infrared spectroscopy); 34.7% of respondents were from Europe and 52.0% were from Asia (45.4% from Japan). The most commonly reported indications for IVI were optimization of stenting (88.5%), procedural/strategy guidance (79.6%), and guidance of left main interventions (77.0%). Most respondents reported perceived equipoise regarding choice between IVUS and OCT for guidance of coronary intervention. High cost (65.9%) and prolongation of the procedure (35.0%) were the most commonly reported factors limiting use. IVI was used more frequently (>15% of cases guided by IVI) in Japan than Europe (96.6% vs. 10.4%, respectively; P<0.001) and by operators with longer interventional experience. CONCLUSIONS: In a sample of predominantly experienced interventional cardiologists, there was a high rate of personal experience with IVI in clinical practice. The most commonly identified indications for IVI were optimization of stenting, procedural/strategy guidance, and guidance of left main interventions. Variability in practice patterns is substantial according to geographic region and interventional experience.