While the use of intravascular ultrasound (IVUS) during coronary intervention proved useful in multiple studies, there is limited evidence in the literature regarding its use in specifically in chronic total occlusions. The IVUS may help guide in recognizing the true lumen and better distal positioning, better coverage of stent, an optimal apposition and expansion, diagnose dissections, wall hematomas, etc.
This prospective randomized trial and included 402 patients and had as primary end point cardiac death and target vessel revascularization at 12 months. The primary end point occurred in 2.6% of patients in which IVUS was used and 7.1% of guided by angiography group (p = 0.035). The IVUS group used greater pressure post dilatation and scored higher minimum luminal diameters.
Conclusion
The IVUS improves outcomes to 12 months in patients with chronic total occlusions treated with 2nd generation stents.
Yang-Soo Jang
2014-09-15
Original title: A Prospective, Randomized Trial of Intravascular Ultrasound-Guided Versus Angiography-Guided Drug-Eluting Stent Intervention in Coronary Chronic Total Occlusions.
