Intravascular Ultrasound–Guided Balloon Angioplasty Compared With Stent

Schiele, François; Méneveau, Nicolas; Gilard, Martine; Boschat, J; Commeau, Philippe; Liu, Ming; Sewoke, Pradip; Seronde, Marie‐France; Mercier, Mariette; Gupta, Sanjiv; Bassand, Jean‐Pierre

doi:10.1161/01.cir.0000047212.94399.7e

Cited by 35 publications

(2 citation statements)

References 29 publications

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“…Despite initial evidence of the incremental increase in information provided by IVUS, it was not yet widely adopted in the United States. At least seven randomized trials were conducted to evaluate clinical outcomes and cost-effectiveness of IVUS-guided versus angiography-guided BMS placement [73][74][75][76][77][78][79][80] .…”

Section: The Co-evolution Of Intravascular Ultrasound and The Stentmentioning

confidence: 99%

State-of-art review: intravascular imaging in percutaneous coronary interventions

Nafee,

Shah,

Forsberg

et al. 2023

Cardiology Plus

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The history of intravascular ultrasound (IVUS) and optical coherence tomography (OCT) reflects the relentless pursuit of innovation in interventional cardiology. These intravascular imaging technologies have played a pivotal role in our understanding of coronary atherosclerosis, vascular pathology, and the interaction of coronary stents with the vessel wall. Two decades of clinical investigations demonstrating the clinical efficacy and safety of intravascular imaging modalities have established these technologies as staples in the contemporary cardiac catheterization lab’s toolbox and earning their place in revascularization clinical practice guidelines. In this comprehensive review, we will delve into the historical evolution, mechanisms, and technical aspects of IVUS and OCT. We will discuss the expanding evidence supporting their use in complex percutaneous coronary interventions, emphasizing their crucial roles in optimizing patient outcomes and ensuring procedural success. Furthermore, we will explore the substantial advances that have propelled these imaging modalities to the forefront of contemporary interventional cardiology. Finally, we will survey the latest developments in the field and explore the promising future directions that have the potential to further revolutionize coronary interventions.

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Section: The Co-evolution Of Intravascular Ultrasound and The Stentmentioning

confidence: 99%

State-of-art review: intravascular imaging in percutaneous coronary interventions

Nafee,

Shah,

Forsberg

et al. 2023

Cardiology Plus

View full text Add to dashboard Cite

show abstract

“…In the Balloon Equivalent to Stent (BEST) Study [19], IVUS-guided balloon angioplasty was randomly compared with systematic stenting. A total of 132 patients were randomized to IVUS-guided balloon angioplasty, and 122 were randomized to stenting.…”

Section: Introductionmentioning

confidence: 99%

IVUS-Guided Stent Implantation to Improve Outcome: A Promise Waiting to be Fulfilled

Rogacka¹,

Latib

Colombo

2009

CCR

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The use of intravascular ultrasound (IVUS) to improve acute angiographic results was already shown in the prestent era. Various studies demonstrated the efficacy of IVUS in balloon sizing and estimating the extent of positive remodeling. With the introduction of drug-eluting stents (DES) the rate of restenosis has been significantly reduced but a new concern, the risk of stent thrombosis, has emerged. The association of stent underexpansion with stent thrombosis was observed for bare metal stents (BMS) and DES. Until now, the criteria for IVUS optimization used in different studies have relied on distal reference or on mean reference vessel for stent or postdilatation balloon sizing. Furthermore, an important recent innovation not available in previous studies is the use of noncompliant balloons to perform high pressure post-dilatation. Universal and easily applicable IVUS criteria for optimization of stent implantation as well as randomized studies on IVUS-guided DES implantation are necessary to minimize stent malapposition and underexpansion, which in turn can positively influence the rates of stent restenosis and thrombosis.

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Does IVUS guidance of coronary interventions affect outcome? a prime example of the failure of randomized clinical trials

Colombo

2008

Cathet Cardio Intervent

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There has been a decline in the role of intravascular ultrasound (IVUS) guiding stenting. IVUS has lost favor with interventional cardiologists largely due to the emergence of drug eluting stents (DES). The advent of DES has lowered the need to maximize the final result due to the known low late-loss. This phenomenon has contributed to reduced interest in optimizing results with IVUS guidance. However, current concerns regarding stent thrombosis in relation to DES and its associated significant morbidity and mortality has once more focused attention on optimal stent deployment. Prior to DES, the evidence base was rather ambiguous, as some randomized and observational studies supported IVUS guided bare metal stent insertion in terms of reducing rates of restenosis and clinically driven target lesion revascularisation whereas others demonstrated no such benefit. As there is an additional cost and learning curve with IVUS, it has become difficult to justify its routine use. We present here a contemporary argument for the resurgence of IVUS optimized stent insertion. We also highlight deficiencies in previously adopted IVUS optimization criteria, which were based on distal and proximal lumen sizes. The new criteria proposed are based on vessel size at different segments of the stented area and therefore take advantage of vessel remodeling. The availability of high pressure, non-compliant balloons have made attainment of these new optimization targets possible without increasing the risk of complications. We hope to demonstrate this statement with the completion of the angiographically versus IVUS optimization (AVIO) study that soon will be initiated.

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Intravascular Ultrasound–Guided Balloon Angioplasty Compared With Stent

Cited by 35 publications

References 29 publications

State-of-art review: intravascular imaging in percutaneous coronary interventions

State-of-art review: intravascular imaging in percutaneous coronary interventions

IVUS-Guided Stent Implantation to Improve Outcome: A Promise Waiting to be Fulfilled

Does IVUS guidance of coronary interventions affect outcome? a prime example of the failure of randomized clinical trials

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