The potential clinical utility of intravascular ultrasound guidance in patients undergoing percutaneous coronary intervention with drug-eluting stents

Section: Discussionmentioning

confidence: 91%

Cardioprotective Effects of Oral Nicorandil Use in Diabetic Patients Undergoing Elective Percutaneous Coronary Intervention

Shehata

2014

“…IVUS guidance was associated with a reduction in stent thrombosis, myocardial infarction, and major adverse cardiac events in early and longterm clinical events. [13][14][15][16] Despite the clinical benefit of IVUS, it could not provide detailed structural information due to lower resolution. However, the OCT-detected minor abnormalities may not require additional treatment.…”

Section: Discussionmentioning

confidence: 99%

“…[6][7][8][9][10][11][12] IVUS-guided stent implantation is associated with a reduction in early and long-term clinical events. [13][14][15][16] Compared to IVUS, OCT can provide detailed morphology information of diseased coronary artery. OCT is capable of detecting dissection caused by balloon inflation, tissue protruding through stent struts, and unapposed stent struts otherwise missed by IVUS in patients undergoing coronary stenting.…”

Section: Introductionmentioning

confidence: 99%

A Comparison of Intravascular Imaging Modalities for Detection of Stent Struts in Acute Coronary Syndrome

Hyeon

Lee

Kim

et al. 2016

“…While this remains unproven, a retrospective study from the Washington Hospital Center suggested that IVUS guidance remains a significant predictor of freedom from stent thrombosis at 12 months after drug-eluting stent implantation. 27 Moreover, recent studies from Korea have suggested mortality benefits for IVUS-guided drugeluting stent implantation in complex lesions such as left main and bifurcation. 28,29 The role, magnitude of benefit, and cost effectiveness of IVUS-guided drugeluting stent implantation will have to be addressed by large-scale prospective studies.…”

Section: Future Directionsmentioning

confidence: 99%

Intravascular Ultrasound Guided Percutaneous Coronary Intervention: A Practical Approach

Lee

2011

Percutaneous coronary intervention (PCI) with stent implantation has become the predominant revascularization therapy for coronary artery disease. However, stent thrombosis and instent restenosis remain 2 major complications. Limitations of stand-alone angiographic guidance play a significant role in the pathogenesis of these complications. Intravascular ultrasound (IVUS) guidance intuitively offers the best chance of optimizing the acute procedural outcomes, which translates to lower incidences of thrombosis and restenosis. This article aims to provide a practical approach on preintervention and postintervention lesion assessment by IVUS. Emphases of this article are on correct interpretation and application of the various vascular parameters obtained during IVUS imaging. Although consensus on some areas is lacking, the most commonly agreed IVUS concepts and criteria are presented. Limitations of the IVUS-guided PCI on routine clinical practice are also addressed. A summary of the randomized study comparing IVUS- versus angiographic-guided PCI, together with a critical appraisal of the data, are also presented. The roles of IVUS in PCI are likely to undergo revolutionary change in the era of plaque characterization and drug-eluting stents.