Citation: International Journal of Cardiology. 340:17-21, 2021 Oct 01.; .Journal: International journal of cardiology.Published: 2021; ; ISSN: 0167-5273.Full author list: Ben-Dor I; Chen Y; Dheendsa A; Garcia-Garcia HM; Hashim H; Khalid N; Mintz GS; Musallam A; Rogers T; Shlofmitz E; Torguson R; Waksman R; Zhang C.UI/PMID: 34371029.Subject(s): *Coronary Artery Disease | *Coronary Restenosis | *Drug-Eluting Stents | *Percutaneous Coronary Intervention | Coronary Angiography | Coronary Restenosis/dg [Diagnostic Imaging] | Coronary Restenosis/et [Etiology] | Humans | Percutaneous Coronary Intervention/ae [Adverse Effects] | Treatment Outcome | Ultrasonography, InterventionalInstitution(s): MedStar Heart & Vascular InstituteActivity type: Journal Article.Medline article type(s): Journal ArticleDigital Object Identifier: https://dx.doi.org/10.1016/j.ijcard.2021.08.003 (Click here)Abbreviated citation: Int J Cardiol. 340:17-21, 2021 Oct 01; .Abstract: BACKGROUND: Percutaneous coronary intervention (PCI) for in-stent restenosis (ISR) remains common. Intravascular imaging allows for the determination of the mechanism of ISR, potentially guiding appropriate therapy. Intravascular ultrasound (IVUS)-guided stent implantation is associated with a reduction in adverse events after PCI, but its impact on treatment of ISR is not clear.Abstract: CONCLUSIONS: The use of IVUS is associated with decreased MACE at 1 year following PCI for ISR. These results support routine IVUS for the treatment of ISR lesions. Copyright (c) 2021. Published by Elsevier B.V.Abstract: METHODS: All patients with 1-year follow-up after ISR treatment from 2003 through 2016 were included and stratified by IVUS use. The primary endpoint was the rate of major adverse cardiac events (MACE) at 1 year, defined as the composite of all-cause mortality, Q-wave myocardial infarction, and target vessel revascularization (TVR).Abstract: RESULTS: The final analysis included 1522 ISR patients, 65.9% of whom were treated with IVUS guidance. The primary endpoint occurred in 18.0% of patients treated with IVUS guidance vs. 24.5% of patients treated with angiography guidance (p = 0.0014). Post-dilatation was used more often with IVUS (18.6% vs. 14.1%, p < 0.001), with a larger diameter of new stents (3.04 +/- 0.35 mm vs. 2.94 +/- 0.47 mm, p = 0.001). At 1 year, TVR occurred in 14.5% with IVUS guidance and 19.2% with angiography guidance (p = 0.021).