Intravascular Imaging and Cardiovascular Events After Complex PCIs
Study Overview
This study examines how intravascular imaging during percutaneous coronary interventions (PCIs) can lead to better outcomes for patients with complex coronary artery issues compared to traditional methods. However, the effects of poor imaging results, like stent underexpansion or malapposition, are not fully understood with modern drug-eluting stents.
Research Methods
The research analyzed data from the RENOVATE-COMPLEX-PCI trial, which compared imaging-guided PCI to angiography-guided PCI in patients with complex lesions. Key findings from imaging after PCI, such as minimum stent area (MSA) and any complications, were evaluated. The main focus was on target lesion failure (TLF), which includes serious heart events related to the treated area.
Key Findings
A total of 897 lesions from 714 patients were studied over an average follow-up of 2.1 years. The results showed:
- The optimal MSA value to predict TLF was 5.5 mm2. An MSA below this level significantly increased the risk of TLF (2.2% vs. 4.8%).
- Patients with MSA above 5.5 mm2 but with issues like stent underexpansion or malapposition also faced a higher risk of TLF (0.0% vs. 3.2%).
- Those with MSA below 5.5 mm2 and poor imaging results had a notably increased risk of TLF (0.0% vs. 4.7%).
Conclusions
The study concludes that inadequate stent expansion is linked to a higher risk of complications after imaging-guided PCI. Poor imaging results, such as stent underexpansion and malapposition, also contribute to this risk.
Clinical Implications
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