Acute and one-year clinical outcomes of pre-stenting intravascular ultrasound: A patient-level meta-analysis of randomised clinical trials

Sung Jin Hong, Daehoon Kim, Byeong Keuk Kim, Chul Min Ahn, Jung Sun Kim, Young Guk Ko, Donghoon Choi, Myeong Ki Hong, Yangsoo Jang

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

Background: Pre-stenting intravascular ultrasound (IVUS) assessment is helpful for appropriate stent sizing and determination of the stent landing zone during percutaneous coronary intervention. Aims: The aim of this meta-analysis was to investigate the effect of pre-stenting IVUS evaluation on procedural and clinical outcomes for diffuse lesions treated with drug-eluting stents (DES). Methods: In four randomised trials comparing IVUS- and angiography-guided DES placement, a total of 1,396 patients who underwent DES implantation with IVUS guidance were identified. Pre-stenting IVUS assessment was performed in 905 patients along with post-stenting IVUS (65%; pre-stenting IVUS(+) group). Post-stenting IVUS evaluation alone was conducted on 491 patients (35%; pre-stenting IVUS(-) group). Results: The pre-stenting IVUS(+) group had a larger angiographic minimal lumen diameter and IVUSderived minimal stent area (MSA) than did the pre-stenting IVUS(-) group. After adjusting, these findings were consistent. The one-year composite of cardiac death, myocardial infarction, and target vessel revascularisation did not differ between the groups. In subgroup analysis, the pre-IVUS(+) group was significantly favoured over the pre-IVUS(-) group in the subset of patients with acute myocardial infarction and lesions with small vessels in terms of larger MSA, and in the subset of patients with chronic total occlusions in terms of better clinical outcomes. Conclusions: Pre-stenting IVUS assessment prior to DES placement was associated with better acute procedural outcomes, though this did not translate into one-year clinical outcomes in the context of poststenting IVUS assessment.

Original languageEnglish
Pages (from-to)202-211
Number of pages10
JournalEuroIntervention
Volume17
Issue number3
DOIs
Publication statusPublished - 2021 Jun

Bibliographical note

Funding Information:
This study was supported by grants from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute funded by the Ministry of Health & Welfare, Republic of Korea (no.: HI17C0882, HI16C2211, and HI15C2782), the Bio & Medical Technology Development Program of the National Research Foundation funded by the Korean government (no.: 2015M3A9C6031514), and the Cardiovascular Research Center, Seoul, Republic of Korea.

Publisher Copyright:
© Europa Digital & Publishing 2021. All rights reserved.

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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