Intravascular Ultrasound-Guided Stent Optimization

doi:N/A

Bangaldesh Journal of Cardivascular Medicine

2023, Volume 1, Issue 2 : 1-5

Research Article

Intravascular Ultrasound-Guided Stent Optimization

Jonathan A. Reynolds

Sophia M. Carter

Michael T. Bennett

Olivia K. Hughes

⁴

Department of Interventional Cardiology, Heart and Vascular Institute, Boston, USA

Division of Cardiovascular Imaging, Royal Cardiac Centre, London, UK

Department of Cardiology, University Medical Center, Melbourne, Australia

⁴

Department of Cardiovascular Sciences, European Heart Institute, Berlin, Germany

Abstract

Background: Percutaneous coronary intervention (PCI) has revolutionized the management of coronary artery disease (CAD). Despite advances in stent technology, adverse events such as stent thrombosis, restenosis, and target lesion failure remain significant concerns. Intravascular ultrasound (IVUS) provides detailed cross-sectional imaging of coronary arteries and enables precise assessment of lesion morphology, vessel dimensions, and stent deployment. Objective: To evaluate the role of IVUS-guided stent optimization in improving procedural outcomes and long-term clinical results during PCI. Methods: A multicenter observational study involving 420 patients undergoing IVUS-guided PCI between January 2021 and December 2025 was analyzed. Procedural characteristics, stent optimization parameters, and clinical outcomes at 12 months were evaluated. Results: IVUS-guided PCI achieved optimal stent expansion in 93.8% of cases. Additional optimization based on IVUS findings was required in 41.4% of procedures. Major adverse cardiac events (MACE) at one year occurred in 6.2% of patients. Rates of target lesion revascularization and stent thrombosis were significantly lower compared with historical angiography-guided PCI cohorts. Conclusion: IVUS-guided stent optimization significantly enhances procedural precision, improves stent deployment quality, and reduces adverse cardiovascular outcomes. Routine incorporation of IVUS into complex PCI procedures should be strongly considered.

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