Intravascular ultrasound guided coronary bifurcation stent implantation

Business News Agency January 12th When intravascular ultrasound-guided intervention (IVUS) can improve the long-term effects of surgery when patients need stenting due to coronary artery branch lesions, Korean researchers published the results in the January issue of the American Heart. Magazine.

In addition to new techniques and new types of stents, bifurcation lesions have a lower success rate than undifferentiated lesions, resulting in adverse clinical outcomes.

To explore whether intravascular ultrasound guidance (IVUS) can improve the outcome of surgery, Dr. Myeong-Ki Hong from Yonsei University Medical School in Seoul, South Korea, and his colleagues analyzed the registration data of more than 900 patients: 487 of them were in blood vessels. A drug-eluting stent was implanted under IVUS (IVUS) and another 487 patients were implanted with the same stent guided by angiography.

In general, the angiogram-guided group has more frequent myocardial enzyme elevations than the intravascular ultrasound-guided group. Two subacute stent thromboses were also seen in the angiographic guided group, while none was found in the intravascular ultrasound guided group. However, the total success rate of the two major vessels and collateral circulation is similar.

After an average of two years of follow-up, the incidence of target lesion revascularization in the IVUS and angiography-guided groups was 7.4% and 6.7%, respectively, with no significant difference. The incidence of major adverse vascular events at the composite end point of the trial included death, myocardial infarction, and revascularization of target lesions, which were also similar: 10.9% and 12.1%, respectively.

However, the incidence of death or myocardial infarction in the angiography-guided group was almost twice that of the intravascular ultrasound-guided group (7.8% vs. 3.8%).

Clinical retrospective studies have some important limitations. Despite this, the authors believe that intravascular ultrasound guidance (IVUS) can improve clinical outcomes, and they concluded that their findings still need to be confirmed in larger clinical randomized trials.

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