Intravascular Ultrasound-Guided or Angiography-Guided Complex High-Risk PCI - PubMed
3 hours ago
- #Clinical Trials
- #Interventional Procedures
- #Cardiology
- IVUS-guided PCI compared to angiography-guided PCI in complex high-risk PCI did not show significant reduction in target-vessel failure.
- The study was an international, open-label, randomized controlled trial with 2020 patients, split between IVUS-guided (1010) and angiography-guided (1009) groups.
- Primary endpoint was target-vessel failure, comprising death from cardiac causes, target-vessel myocardial infarction, or clinically indicated revascularization.
- At a median follow-up of 19.0 months, IVUS-guided PCI had a target-vessel failure rate of 13.9% vs. 11.1% for angiography-guided PCI, with a hazard ratio of 1.25 (P=0.08).
- IVUS-guided PCI procedures were longer on average (88.8 minutes) compared to angiography-guided (66.2 minutes) and had higher rates of balloon dilation post-stent implantation (91.3% vs. 84.5%).
- Complication rates were similar between groups (11.3% for IVUS-guided vs. 10.2% for angiography-guided), indicating no significant safety advantage for either method.
- The study concluded that routine IVUS guidance using prespecified optimization criteria did not lower risk of adverse outcomes compared to angiography guidance alone in complex PCI.