734-3 The Safety of Intracoronary Ultrasound: Data from a Multicenter European Registry

Abstract

The clinical use of intracoronary ultrasound (ICUS) is growing, serving as a useful adjuvant to contrast angiography, and providing additional information to assist with catheter based interventions. Despite the increasing use of this technique, it remains an invasive procedure which the safety has not been definitively established. Data was collected from multiple European centers performing intracoronary ultrasound examinations under the auspices of the Subgroup on Intravascular Ultrasound of the Working Group on Echocardiography of the European Society of Cardiology. Information was obtained about the number of exams performed, complications related to imaging, patient's age and CAD risk factors, indication for exam, concomitant procedures performed, catheter size and location, and any adverse clinical consequences related to ICUS imaging. Twelve centers (mean 59 patients, range 3–140) submitted information about their experience with ICUS. A total of eight (1.1%) complications were reported in a total of 718 examinations. All complications occurred during ICUS exams in patients with atherosclerotic coronary disease with a diagnosis of unstable or stable angina who underwent PTCA. Four cases of transient vessel spasm were seen, all of which resolved after administration of nitroglycerin. Two cases of vessel dissection were noted when imaging after PTCA, and thought to be “possibly” related to the ultrasound catheter. Two cases of guidewire entrapment after distal advancement of the transducer were reported, requiring the catheter and guidewire to be withdrawn. No adverse clinical consequences due to ICUS imaging were reported. There was no difference in frequency of complications between centers assessed by Chi square (p = 0.232). Intracoronary ultrasound examinations can be performed safely with a very low rate of acute complications.