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ȣ - 490207 231 |
| IVUS Guidance Stenting in Long De Novo Coronary Lesions Is Not Associated with Improved Clinical Outcomes in Drug-eluting Stent Era |
| 연세대학교 신촌세브란스병원 심장내과 |
| 안철민, 고영국, 김진배, 심재민, 문정근, 강태수, 김종윤, 박성하, 최동훈, 장양수, 정남식, 심원흠, 조승연 |
Background: The purpose of this study was to evaluate efficacy and clinical outcomes of intravascular ultrasound-guided stenting for the treatment of long coronary lesions in DES era. Methods: Since January/03 to September/04, 76 long lesions (>25mm) with IVUS-guided DES implantation and 232 long lesions treated with angiography–guided DES implantation were enrolled. Primary end points were death, myocardial infarction, ischemia-driven target vessel and lesion revascularization within 9 months of index stent procedure.Results: Table 1. Conclusions: Clinical outcomes of IVUS-guided stenting for the treatment of long de novo coronary lesions in DES era are not superior to those of angiography-guided stenting. These data suggest that the routine performance of IVUS during long lesion intervention in DES era does not improve angiographic and clinical outcome at 9 months.
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IVUS-guided (n=76) |
Angio-guided(n=232) |
P-value |
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Age yrs |
62.6 ± 9.3 |
61.6 ± 10.2 |
NS |
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Male.(%) |
51 (67.1) |
166 (71.6) |
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DM (%) |
26 (34.2) |
94 (40.5) |
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Hypertension (%) |
43 (56.6) |
147 (63.4) |
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Hypercholesterolemia(%) |
20 (26.3 ) |
57 (24.6) |
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Non-MI/MI(%). |
63/13 ( 82.9/ 17.1) |
172/60 ( 74.1 /25.9) |
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Cypher/Taxus stent (%) |
75/35 ( 68/ 32) |
262/90 ( 74/ 26) |
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Lesion Length |
38.1 ± 13.1 |
36.7 ± 13.5 |
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PreMLD/PostMLD |
0.6 ± 0.38/ 2.6 ± 0.44 |
0.6 ± 0.44/ 2.6 ± 0.48 |
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Acute gain |
2.0 ± 0.59 |
2.0 ± 0.6 |
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Late loss - 9 mon |
0.17 ± 0.69 (n=45/76) |
0.25 ± 0.62 (n=137/232) |
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In-stent restenosis (%) |
5 (11) (n=45/76) |
14 (10) (n=45/76) |
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30 days MACE (%) |
0 |
2(0.9) |
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9 mon MACE(%) |
Death |
0 |
2(0.9) |
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MI |
0 |
1(0.4) |
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TVR,TLR |
5(6.6) |
13(5.6) |
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