Title Intravascular ultrasound guidance is associated with a favorable one-year target vessel failure rate and no residual myocardial ischemia after the percutaneous treatment of very long coronary artery lesions /
Authors Budrys, Povilas ; Baranauskas, Arvydas ; Davidavičius, Giedrius
DOI 10.3390/jcdd9120445
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Is Part of Journal of cardiovascular development and disease.. Basel : MDPI. 2022, vol. 9, iss. 12, art. no. 445, p. [1-12].. eISSN 2308-3425
Keywords [eng] FFR ; fractional flow reserve ; intravascular ultrasound ; IVUS ; long coronary artery lesions ; percutaneous coronary intervention
Abstract [eng] Background: Studies have shown that percutaneous coronary intervention (PCI) in long coronary artery lesions (≥30 mm) is associated with more frequent target vessel failure (TVF), and a significant proportion of patients have lesions that continue to induce ischemia after PCI (FFR ≤ 0.8). We investigated the impact of intravascular ultrasound (IVUS) on the functional PCI result and one-year TVF rate after the percutaneous treatment of long coronary artery lesions. Methods: A total of 80 patients underwent IVUS-guided PCI in long coronary artery lesions. The PCI results were validated with IVUS and FFR. Procedural outcomes were the proportion of patients with: (1) optimal physiology result (post PCI FFR value ≥ 0.9); (2) optimal anatomy result (all IVUS PCI optimization criteria met); and (3) optimal physiology and anatomy result. The clinical outcome was TVF during a one-year follow-up (target vessel (TV)-related death, TV myocardial infarction, ischemia-driven TV revascularization). Results: The mean stented segment length was 62 mm. The target vessel (TV) was the left anterior descending artery in 82.5% of cases. There were no patients with residual ischemia (FFR ≤ 0.8) after PCI. Optimal coronary flow (FFR ≥ 0.9) was achieved in 37.5%; optimal anatomy, as assessed by IVUS, was achieved in 68.4%; and both optimal flow and anatomy were achieved in 25% of patients. Target vessel failure during the 12-month follow-up was 2.5%. Conclusions: In the percutaneous treatment of very long coronary artery lesions, the use of IVUS guidance is associated with a low TVF rate during a one-year follow-up and no residual myocardial ischemia, as assessed by FFR.
Published Basel : MDPI
Type Journal article
Language English
Publication date 2022
CC license CC license description