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.