TCT-688 Utility of Intravascular Ultrasound in Optimizing Outcomes Following Coronary Covered Stent Deployment

Document Type

Conference Proceeding

Publication Date

10-28-2025

Publication Title

J Am Coll Cardiol

Abstract

Background: Intravascular ultrasound (IVUS) has been shown to enhance outcomes in percutaneous coronary interventions (PCI), particularly through improved stent sizing and expansion. In this study, we investigated the role of IVUS in patients who required covered stents for the treatment of coronary artery perforation (CAP). Methods: We conducted a retrospective analysis of 131 patients treated with either Papyrus or GraftMaster covered stents for CAP between December 2014 and January 2024. Patients were divided into two cohorts: those who received IVUS-guided PCI and those who did not. The primary outcomes assessed included procedural success, stent thrombosis, in-stent restenosis, and the requirement for additional covered stents. Statistical comparisons were performed using chi-square tests, with significance defined as p < 0.05. Results: Of the 131 patients, 34 (26.0%) underwent IVUS-guided stent implantation. Procedural success was significantly higher with IVUS (88.2% vs. 65.8%, p = 0.000047), and stent thrombosis was lower (0.0% vs. 7.9%, p = 0.0079). In-stent restenosis rates were similar (12.9% vs. 16.1%, p = 1.00). The need for a second covered stent was markedly reduced with IVUS (5.9% vs. 34.2%, p = 0.000008). [Formula presented] Conclusion: Use of IVUS in the management of CAP requiring covered stents was associated with improved procedural success and lower rates of both stent thrombosis and need for additional stents. These findings suggest that IVUS may play an important role in optimizing outcomes when deploying covered stents in emergent PCI settings. Categories: IMAGING AND PHYSIOLOGY: Imaging: Intracoronary

Volume

86

Issue

17

First Page

B300

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