TCT-56 Effectiveness of Image-Guided Percutaneous Coronary Intervention in Contemporary Practice: Insights From BMC2

Document Type

Conference Proceeding

Publication Date

10-29-2024

Publication Title

J Am Coll Cardiol

Abstract

Background: Studies show that intracoronary imaging (ICI)-guided percutaneous coronary intervention (PCI) results in larger stent/balloon diameters and longer stent length. Whether these findings are seen in real-world practice is poorly understood. Methods: Between July 2019 and June 2022, there were 74,621 lesions treated at 48 non-federal hospitals in Michigan. Associations between ICI use for de novo lesion PCI optimization with maximum balloon/stent diameters and total stent length were evaluated using regression models controlling for patient and procedural factors. A sensitivity analysis controlling for the operator was performed. Results: ICI was used in 16,777 (22.5%) PCI-treated lesions. Compared with angiography alone, ICI use was associated with larger stent diameters (median 3.50 mm [3.00, 3.50] vs 3.00 mm [2.50, 3.50]), larger maximum balloon diameters (3.50 mm [3.00, 4.50] vs 3.00 mm [2.50, 3.50]), and longer stent lengths (32.00 mm [22.00, 48.00] vs 24.00 mm [18.00, 38.00]) (p<0.001 for all) (Figure 1). Average patient/procedural adjusted treatment effects included: +0.19-mm stent diameter (95% CI: +0.16-0.22), +0.45-mm maximum balloon diameter (95% CI: +0.40-0.51), and +3.51-mm stent length (95% CI: +2.54-4.48). These findings persisted when controlling for the operator (Figure 1). [Formula presented] Conclusion: In real-world practice, ICI-guided PCI was associated with larger stent/balloon diameters and longer stents. Categories: IMAGING AND PHYSIOLOGY: Imaging: Intravascular.

Volume

84

Issue

18

First Page

B175

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