Erschienen in:
01.05.2020 | Coronary Artery Disease (D Feldman and V Voudris, Section Editors)
Improving Outcomes With IVUS Guidance During Percutaneous Coronary Interventions
verfasst von:
Vinayak Nagaraja, Ankur Kalra, Rishi Puri
Erschienen in:
Current Treatment Options in Cardiovascular Medicine
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Ausgabe 5/2020
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Abstract
Purpose of review
This review highlights the evidence surrounding the adjunctive diagnostic and therapeutic benefits of intravascular ultrasound (IVUS) during percutaneous coronary intervention (PCI).
Recent findings
Meta-analyses of randomized trials demonstrate that IVUS has a major impact on PCI-related outcomes with drug-eluting stents by reducing cardiovascular mortality and repeat revascularization. Its application in calcific coronary artery disease has helped identify the benefits and safety of coronary atherectomy, along with playing an important role for primarily guiding PCI while significantly reducing contrast volume in individuals with renal dysfunction. IVUS applications have been extended to the realms of CTO intervention, aneurysmal coronary disease, and iatrogenic/spontaneous coronary artery dissection. IVUS is also a proven cost-effective strategy. Nevertheless, despite these benefits, the global uptake of IVUS-guided PCI remains low.
Summary
IVUS plays a pivotal role during PCI, particularly complex calcific and long lesions. IVUS-guided PCI is safe, cost-effective, and associates with substantial reductions in MACE. However, the worldwide uptake of IVUS-guided PCI remains considerably low. Further efforts are required to promote this evidence-based PCI strategy among the global interventional cardiology community to further improve the outcomes of our PCI candidates.