Mohammad Nasir Rahman1, Ihsan Ullah1, Ghufran Adnan1
1The Aga Khan University Hospital, Karachi, Pakistan
IVUS technology has been proven to be superior to coronary angiography for assessment of vessel size, plaque composition, calcium content and lesion severity, despite this benefit, routine IVUS use is limited by cost considerations and additional time that is needed to perform the procedure.
An ambi directional cohort study in which we studied our last ten years data of IVUS from June 2010 t0 2020. The primary study end point was target vessel failure (TVF), including cardiac death, target vessel-related MI, and clinically driven target vessel revascularization (CDTVR) and MACE during the follow-up. Target vessel was defined as the vessel in which IVUS measurement was performed.
Total number of patients were 134 (72.4% male, 27.6% were female) 23.1% were presented as STEMI while 37.3%, 9.7% and 29.1% were NSTEMI, USAP and stable angina respectively. Cardiogenic shock patients were 6.7% on presentation. IVUS of LAD was performed in 70% followed by IVUS of LM in 32.1%. IVUS guided stenting done in 74.6%, POBA was done in 11.9% and Rota ablation was done in 1.5% of cases. Mean size of stent used was 3.1 x 24.2. Coronary artery dissection was diagnosed in 9.8% cases. Xience xpedition and prime were used in majority as 37.6 and 15.8%. MACE was observed in 2.3% in the same hospital sitting. Mean follow up was 617 days. On follow up target vessel PCI done in 0.8%, ISR observed in target vessel was 0.8%, CABG was done in 1.6% and all-cause mortality was 0.8% of the cases
IVUS guided complex PCI results in significantly lower rates of MACE, target vessel failure including target vessel related MI and clinically driven target vessel revascularization.