TY  - BOOK
AU  - Ben-Dor, Itsik
AU  - Chen, Yuefeng
AU  - Craig, Paige E
AU  - Garcia-Garcia, Hector M
AU  - Hashim, Hayder
AU  - Khalid, Nauman
AU  - Mintz, Gary S
AU  - Rogers, Toby
AU  - Satler, Lowell F
AU  - Shlofmitz, Evan
AU  - Torguson, Rebecca
AU  - Waksman, Ron
AU  - Zhang, Cheng
TI  - Impact of Intravascular Ultrasound on Outcomes Following PErcutaneous Coronary InterventioN in Complex Lesions (iOPEN Complex)
SN  - 0002-8703
PY  - 2020///
KW  - *Coronary Artery Disease/su [Surgery]
KW  - *Percutaneous Coronary Intervention/mt [Methods]
KW  - *Ultrasonography, Interventional/mt [Methods]
KW  - Aged
KW  - Atherectomy, Coronary
KW  - Coronary Angiography
KW  - Drug-Eluting Stents
KW  - Female
KW  - Hospital Mortality
KW  - Humans
KW  - Male
KW  - Middle Aged
KW  - Mortality
KW  - Myocardial Infarction/ep [Epidemiology]
KW  - Myocardial Revascularization/sn [Statistics & Numerical Data]
KW  - Stents
KW  - Surgery, Computer-Assisted/mt [Methods]
KW  - MedStar Heart & Vascular Institute
KW  - Journal Article
N1  - Available online from MWHC library: 1995 - present, Available in print through MWHC library: 1999 - 2006
N2  - 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; 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; 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; 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
UR  - https://dx.doi.org/10.1016/j.ahj.2019.12.008
ER  -