THE UTILITY OF ROUTINE INTRA-VASCULAR ULTRASOUND DURING PERCUTANEOUS CORONARY INTERVENTION OF SAPHENOUS VEIN GRAFTS.

Abstract

Abstract Category: Intravascular DiagnosticsPresentation Number: 2503-509Authors: Asmir I. Syed, Gabriel Maluenda, Itsik Ben-Dor, Manuel A. Gonzalez, Michael A. Gaglia, Cedric Delhaye, Loic Belle, Kohei Wakabayashi, Nicholas Hanna, Sara D. Collins, Rebecca Torguson, Zhenyi Xue, Nelson Bernardo, William O. Suddath, Kenneth M. Kent, Lowell F. Satler, Augusto D. Pichard, Joseph Lindsay, Ron Waksman, Washington Hospital Center, Washington, DC Background: Intra-vascular Ultrasound (IVUS) use during Percutaneous Coronary Intervention (PCI) of native coronaries has been used to study lesion and vessel characteristics. It is unknown whether routine IVUS use in PCI of a saphenous vein graft (SVG) is beneficial.Methods: A cohort of 543 patients who underwent SVG PCI ( 375 in IVUS group, 171 in the no IVUS group) were followed clinically up to 1 year and the clinical events were recorded and compared between the two groups. Patients presenting with myocardial infarction, cardiogenic shock, and multi-vessel or native vessel PCI were excluded. The primary composite endpoints were in-hospital major complications and major adverse cardiac events (MACE) at 1 year. Peri-procedural MI was defined as maximum troponin I greater then 3 times the baseline troponin I.Results: Baseline and procedural characteristics were similar [see Table]. IVUS group had significantly longer procedural length and higher restenosis lesions. In-hospital complications, peri-procedural myocardial infarction, and no-reflow phenomenon were similar between the two groups. At 1 year, IVUS group had significantly higher MACE then the no IVUS group (22.7% vs 14.6%, p=0.03). On multivariate analysis, IVUS was not an independent predictor of MACE. [HR, 1.57 (0.95-2.60), p=0.07)Conclusion: Routine IVUS for SVG PCI is safe but does not improve in-hospital or long term outcomes.Table