TCT-55 Safety 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 better patient outcomes. However, the association between ICI use and risks of dissection and perforation 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. We evaluated associations between ICI use for de novo lesion PCI with dissections/perforations using regression models controlling for patient and procedural factors. We assessed temporal trends in ICI use, stent/balloon sizes, and rates of dissection/perforation. Results: ICI was used in 16,777 (22.5%) PCI-treated lesions and increased from 11.2% of cases in July 2019 to 32.1% in June 2022. ICI use was associated with a higher risk for dissections (aOR: 2.55; 95% CI: 2.05-3.16) and perforations (aOR: 2.25; 95% CI: 1.74-2.91). However, increased use of ICI and larger average maximal stent/balloon diameters over the study period (P < 0.001 for trend for both) was not associated with a concomitant increase in rates of dissection or perforation (P = 0.78 and P = 0.33 for trend, respectively) (Figure 1), suggesting that at least some of the ICI use was in response to the complication. [Formula presented] Conclusion: In real-world practice, although ICI use was associated with dissections and perforations, there was no significant increase in these complications despite significant increases in ICI use during the study period. Categories: IMAGING AND PHYSIOLOGY: Imaging: Intravascular.

Volume

84

Issue

18

First Page

B174

Last Page

B175

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