Routine intravascular ultrasound scanning guidance of coronary stenting is not associated with improved clinical outcomes

American Heart Journal
James L OrfordPRESTO Investigators

Abstract

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. 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. These data suggest that the routine performance of IVUS during stent placement influences the performance of the procedure, as jud...Continue Reading

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Citations

Mar 24, 2009·Archives of Cardiovascular Diseases·Laurent BonelloRon Waksman
Jan 16, 2007·Investigative Radiology·Marc DeweyBernd Hamm
Jul 4, 2013·Arquivos brasileiros de cardiologia·José Albuquerque de Figueiredo NetoOtavio Berwanger
Dec 26, 2006·Expert Review of Cardiovascular Therapy·Paul Das, Ian Meredith
Jun 20, 2006·Cardiology Clinics·Ilke SipahiE Murat Tuzcu
Aug 9, 2006·The American Heart Hospital Journal·David R Holmes, Charanjit Rihal
Feb 1, 2008·JACC. Cardiovascular Interventions·Enrico RomagnoliAntonio Colombo
Feb 5, 2010·JACC. Cardiovascular Interventions·Yasuhiro Honda, Peter J Fitzgerald
Mar 17, 2005·European Heart Journal·Sigmund SilberUNKNOWN Task Force for Percutaneous Coronary Interventions of the European Society of Cardiology

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