Impact of intravascular ultrasound utilization for stent optimization on 1-year outcomes after chronic total occlusion percutaneous coronary intervention

Evangelia Vemmou, Jaikirshan Khatri, Anthony H. Doing, Phil Dattilo, Catalin Toma, Abdul Sheikh, Khaldoon Alaswad, Brian K. Jefferson, Taral N. Patel, Raj H. Chandwaney, Farouc A. Jaffer, Wissam Jaber, Habib Samady, Fotios Gkargkoulas, Jeffrey W. Moses, Nicholas J. Lembo, Ajay J. Kirtane, Manish Parikh, Ziad A. Ali, Michael MegalyMohamed Omer, Ilias Nikolakopoulos, Iosif Xenogiannis, Larissa Stanberry, Ross F. Garberich, Bavana V. Rangan, Santiago Garcia, M. Nicholas Burke, Shuaib Abdullah, Subhash Banerjee, Emmanouil S. Brilakis, Dimitri Karmpaliotis

Research output: Contribution to journalArticlepeer-review

Abstract

Background. The impact of intravascular ultrasound (IVUS) utilization for stent optimization on the long-term outcomes in chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has received limited study. Methods. We examined the outcomes of CTO-PCI with and without IVUS use for stent optimization in 922 CTO-PCIs performed between 2012 and 2019 at 12 United States centers. Major adverse cardiac event (MACE) was defined as the composite of cardiac death, acute coronary syndrome, and target-vessel revascularization. Results. IVUS was used in 344 procedures (37%) for stent optimization. Mean patient age was 65 ± 10 years and 83% were men. Patients in the IVUS group were less likely to have a prior myocardial infarction (39% vs 50%; P<.01), more likely to undergo right coronary artery CTO-PCI (49% vs 55%; P=.01), and had higher mean J-CTO score (2.6 ± 1.1 vs 2.4 ± 1.2; P=.04). The final crossing strategy in patients in the IVUS group was less likely to be antegrade wire escalation (54% vs 57%) and more likely to be retrograde (29% vs 21%; P<.01). Median follow-up was 141 days (interquartile range, 30-365 days). The incidence of 12-month MACE was similar in the IVUS and no-IVUS groups (20.3% vs 18.3%; log-rank P=.67). Conclusion. IVUS was used for stent optimization in approximately one-third of CTO-PCIs. Despite higher lesion complexity in the IVUS group, the incidence of MACE was similar during follow-up.

Original languageEnglish (US)
Pages (from-to)392-399
Number of pages8
JournalJournal of Invasive Cardiology
Volume32
Issue number10
StatePublished - Oct 2020

Keywords

  • Cto
  • Ivus
  • Stent optimization

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Impact of intravascular ultrasound utilization for stent optimization on 1-year outcomes after chronic total occlusion percutaneous coronary intervention'. Together they form a unique fingerprint.

Cite this