SHBC1291
J. J. F. LOO1, K.F.C.LI2, J. L. P. ONG3, Z. L. D. KHOO2, F. H. JAFARY2, H.H.H2
MOH Holdings Pte Ltd (MOHH)1, Tan Tock Seng Hospital2, Heart Specialist International3
Intravascular ultrasound is under-utilised despite the evidence of improving coronary angioplasty outcomes. We investigate the effects of a bundled intravascular ultrasound (IVUS) plus everolimus-eluting stent (EES) package on utilisation rates and stent outcomes during percutaneous coronary intervention (PCI).
We retrospectively studied the number of stents, stent diameters, largest non-compliant balloon diameters, and total length of the stents implanted in patients before and after the introduction of the IVUS plus EES package.
232 patients were included. Patients undergoing IVUS-guided PCI increased from 21.87% (21 out of 96 patients) to 45.58% (62 out of 136 patients) after package introduction.
There were significantly more stents (1.45 +/- 0.58 vs 1.76 +/- 0.58, p=0.001) and longer length of stents (45.46 +/- 22.57mm vs 57.60 +/- 27.00mm, p=0.00039) after package introduction. There were no significant difference in the stent diameters (3.23 +/- 0.51mm vs 3.17 +/- 0.49mm, p=0.35) and NC balloon diameters (3.77 +/- 0.61mm vs 3.72 +/- 0.68mm, p=0.53).
A separate analysis of PCI with and without IVUS yielded the following findings. Significantly more stents (1.50 +/- 0.71 vs 1.88 +/- 0.83, p= 0.00036), longer lengths (47.13 +/- 23.27mm vs 62.34 +/- 27.60mm, p=0.000013), larger stent diameters (3.13 +/- 0.50mm vs 3.34 +/- 0.49mm, p=0.002), and larger NC diameters (3.68 +/- 0.66mm vs 3.87 +/- 0.58mm (p=0.027) were achieved during IVUS-guided PCI.
Bundling IVUS with EES doubles its usage and increases number of stents implanted. IVUS-guided PCI achieves larger stent sizes which may translate to better patient outcomes.