Impact of intravascular ultrasound guidance in stent deployment on 6-month restenosis rate: a multicenter, randomized study comparing two strategies—with and without intravascular ultrasound guidance

Abstract

A nonsignificant 6.3% absolute reduction in the restenosis rate and a nonsignificant difference in MLD were observed in this study. Nonetheless, we still cannot rule out a beneficial effect of IVUS guidance, although this may have gone undetected owing to a lack of statistical power. A significant increase was observed in immediate and 6-month lumen size, as detected by IVUS, indicating that ultrasound guidance in stent deployment may be beneficial.

Ultrasound-Guided Strategy for Provisional Stenting With Focal Balloon Combination Catheter

“…ICUS-guided stent placement in selected lesions has been associated with restenosis rates of 9.7%, 13.5%, and 22.5% in 3 trials. 19,24,25 By comparison, in the Intracoronary Stenting and Antithrombotic Regimen (ISAR) trial, 26 with broader inclusion criteria, the restenosis rate in the antiplatelet group was 26.8%, and the 6-month TLR rate was 14.6%. Jeremias et al 27 have also used ICUS guidance for stent placement in consecutive patients, achieving a 33.3% restenosis rate at 6 months.…”

Intravascular Ultrasound Guidance Improves Angiographic and Clinical Outcome of Stent Implantation for Long Coronary Artery Stenoses

“…11 However, randomized studies investigating this strategy have yielded inconsistent results. [12][13][14][15][16][17] We hypothesized that the potential advantages of IVUS guidance would be most apparent in complex lesions, such as long stenoses. In this report, we compared the clinical and angiographic outcome after stenting of long coronary artery stenoses with randomization to angiographic or IVUS guidance of the intervention.…”

Efficacy And Safety Of IVUS-Guided Percutaneous Coronary Interventions

“…Documentary data indicate that the differences are related to acquisition in cases involving small and long lesions, such as lesions on venous grafts for which appropriate angiographically obtained data on the lesion type and length (13). Based on a significant increase in DES use in clinical practice, the dependency of stent strut apposition to the vessel is noted and decreases the acute complications of percutaneous interventions (14); in addition, low lumen size estimates, existing diseased segments proximally and distally from the placed stents and existing but unobservable angiographic dissections are predictors of early PCI complications (15). On the other hand, IVUS did not show a significant influence on stent restenosis in patients treated with DES (15).…”