Citation: ; American Heart Journal. 221:74-83, 2020 03..Journal: American heart journal.Published: ; 2020; ; ISSN: 0002-8703.Full author list: Ben-Dor I; Chen Y; Craig PE; Garcia-Garcia HM; Hashim H; Khalid N; Mintz GS; Rogers T; Satler LF; Shlofmitz E; Torguson R; Waksman R; Zhang C.UI/PMID: 31951847.Subject(s): Aged | *Ultrasonography, Interventional/mt [Methods] | Surgery, Computer-Assisted/mt [Methods] | Stents | *Percutaneous Coronary Intervention/mt [Methods] | Myocardial Revascularization/sn [Statistics & Numerical Data] | Myocardial Infarction/ep [Epidemiology] | Mortality | Middle Aged | Male | Humans | Hospital Mortality | Female | Drug-Eluting Stents | *Coronary Artery Disease/su [Surgery] | Coronary Angiography | Atherectomy, CoronaryInstitution(s): MedStar Heart & Vascular InstituteActivity type: Journal Article.Medline article type(s): Journal ArticleOnline resources: Click here to access onlineDigital Object Identifier: https://dx.doi.org/10.1016/j.ahj.2019.12.008 (Click here)Abbreviated citation: ; Am Heart J. 221:74-83, 2020 03.Local Holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006.Abstract: BACKGROUND: Clinical data support the use of intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) as being associated with improved outcomes. Nonetheless, global utilization of IVUS remains low. We hypothesize that, in the revascularization of complex lesions, IVUS use is associated with improved outcomes.Abstract: CONCLUSIONS: Among patients with complex lesions, the use of IVUS was associated with lower MACE 1year after PCI than angiography alone was. Because of the increased procedural risk in complex lesions, routine utilization of IVUS-guided PCI should be considered in this subset of patients. Copyright (c) 2019 Elsevier Inc. All rights reserved.Abstract: METHODS: All patients with complex lesions treated with PCI at a single center from 2003 to 2016 were stratified by use of IVUS. Complex lesions were defined as follows: American College of Cardiology/American Heart Association type C lesions, in-stent restenosis, long lesions, bifurcations, severe calcification, left main lesions, and chronic total occlusions. The primary end point was the rate of major adverse cardiac events (MACE) at 1-year follow-up, defined as the composite of all-cause mortality, Q-wave myocardial infarction, and target vessel revascularization. Inverse probability weighting was used in the adjusted analysis.Abstract: RESULTS: A total of 6,855 patients were included in the final analysis, of whom 67.3% had IVUS and 32.7% had angiography alone. The primary end point occurred in 13.4% of patients treated with IVUS and 18.3% of patients treated with angiography alone (P<.001). Inverse probability weighting-adjusted 1-year MACE rates demonstrated significant reduction with IVUS for each complex lesion type.