TCT 2019 | IVUS-XPL: 5-Year Follow-up for Angiography-vs. IVUS-Guided Angioplasty

Courtesy of SBHCI.

The aim of this work, which was presented during the TCT 2019 Scientific Session and simultaneously published in JACC Intv, was to prove the benefit of intravascular ultrasound (IVUS) in angioplasty.

The IVUS-XPL trial randomized 1400 patients with long coronary lesions (≥28 mm) to IVUS-guided angioplasty (n = 700) vs. angiography-guided angioplasty (n = 700). All procedures were conducted with an everolimus-eluting stent. Follow-up on patients was 5 years.

The primary endpoint was a composite of death, target-vessel-related myocardial infarction, and ischemia-driven revascularization.

About 1183 patients (85%) completed the 5-year follow-up. The composite primary endpoint occurred in 5.6% of patients who underwent IVUS-guided angioplasty vs. 10.7% of patients who underwent angiography-guided angioplasty (hazard ratio [HR]: = 0.5; p = 0.001). The difference was basically driven by lower target-vessel revascularization (4.8% vs. 8.4%; p = 0.007).

Conclusion

Comparing IVUS-guided vs. angiography-guided angioplasty with a drug-eluting stent, the former was associated with significantly lower rates of major cardiac events at 5 years.

Courtesy of SBHCI.

Link to the SBHCI publication HERE

Original Title: IVUS-XPL: 5-Year Outcomes From a Randomized Trial of Intravascular Ultrasound-Guided vs. Angiography-Guided PCI of Long Coronary Lesions.

Author of the original title: Myeong-Ki Hong.

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