Faculty Collaboration Database

Routine intravascular ultrasound scanning guidance of coronary stenting is not associated with improved clinical outcomes. Am Heart J 2004 Sep;148(3):501-6

Date

09/25/2004

Pubmed ID

15389239

DOI

10.1016/j.ahj.2004.03.033

Scopus ID

2-s2.0-4644327580 (requires institutional sign-in at Scopus site)   22 Citations

Abstract

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.

Author List

Orford JL, Denktas AE, Williams BA, Fasseas P, Willerson JT, Berger PB, Holmes DR Jr, PRESTO Investigators

Author

Panayotis Fasseas MD Associate Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Angioplasty, Balloon, Coronary
Coronary Angiography
Coronary Disease
Disease-Free Survival
Double-Blind Method
Female
Humans
Male
Middle Aged
Myocardial Infarction
Risk
Stents
Treatment Outcome
Ultrasonography, Interventional