The Effect of Intravascular Imaging-Guided Percutaneous Coronary Intervention on Coronary Artery Perforation
Background: Intravascular imaging (IVI) complements coronary angiography and may help prevent coronary artery perforation (CAP) during percutaneous coronary intervention (PCI). Objectives: The authors evaluated whether IVI-guided PCI is associated with a lower risk of PCI-related CAP in a real-world...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-01-01
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| Series: | JACC: Asia |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2772374724003508 |
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| author | Yuichi Sawayama, MD Kenta Sasaki, MD Narumi Taninobu, MD Akihiro Ikuta, MD Kohei Osakada, MD Shunsuke Kubo, MD Takeshi Tada, MD Yasushi Fuku, MD Hiroyuki Tanaka, MD Yoshihisa Nakagawa, MD Kazushige Kadota, MD |
| author_facet | Yuichi Sawayama, MD Kenta Sasaki, MD Narumi Taninobu, MD Akihiro Ikuta, MD Kohei Osakada, MD Shunsuke Kubo, MD Takeshi Tada, MD Yasushi Fuku, MD Hiroyuki Tanaka, MD Yoshihisa Nakagawa, MD Kazushige Kadota, MD |
| author_sort | Yuichi Sawayama, MD |
| collection | DOAJ |
| description | Background: Intravascular imaging (IVI) complements coronary angiography and may help prevent coronary artery perforation (CAP) during percutaneous coronary intervention (PCI). Objectives: The authors evaluated whether IVI-guided PCI is associated with a lower risk of PCI-related CAP in a real-world cohort. Methods: This observational study analyzed consecutive PCI procedures from January 2006 to October 2023. The procedures were divided into 4 groups according to the year performed: 2006 to 2010 (P1), 2011 to 2015 (P2), 2016 to 2020 (P3), and 2021 to 2023 (P4). We evaluated the trend of IVI-guided PCI and the incidence of CAP. A mixed effects logistic model was employed to assess their relationship. Results: CAP occurred in 368 (1.6%) of 22,368 PCIs. IVI-guided PCI accounted for 63% of all cases, of which 95% were intravascular ultrasound procedures. From P1 to P3, the ratio of IVI-guided PCI increased linearly (P1: 30%, P2: 61%, P3: 93%, P4: 97%), while the incidence of CAP decreased (P1: 2.10%, P2: 1.74%, P3: 1.13%, P4: 1.18%). IVI-guided PCI showed a significant association with a lower risk of the overall incidence of CAP (adjusted OR: 0.78; 95% CI: 0.61-0.99; P = 0.047). This relationship was particularly significant for chronic total occlusion PCI (adjusted OR: 0.59; 95% CI: 0.43-0.80; P = 0.001) and PCI for moderate or severe calcification (adjusted OR: 0.50; 95% CI: 0.33-0.74; P = 0.001). Conclusions: IVI-guided PCI may help prevent PCI-related CAP, especially in the setting of chronic total occlusion PCI and PCI for moderate or severe calcification. |
| format | Article |
| id | doaj-art-b87f441ed17049079398c4eab1d5a333 |
| institution | Kabale University |
| issn | 2772-3747 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JACC: Asia |
| spelling | doaj-art-b87f441ed17049079398c4eab1d5a3332025-01-09T06:14:54ZengElsevierJACC: Asia2772-37472025-01-01514655The Effect of Intravascular Imaging-Guided Percutaneous Coronary Intervention on Coronary Artery PerforationYuichi Sawayama, MD0Kenta Sasaki, MD1Narumi Taninobu, MD2Akihiro Ikuta, MD3Kohei Osakada, MD4Shunsuke Kubo, MD5Takeshi Tada, MD6Yasushi Fuku, MD7Hiroyuki Tanaka, MD8Yoshihisa Nakagawa, MD9Kazushige Kadota, MD10Department of Cardiovascular Medicine, Kurashiki Central Hospital, Kurashiki, Japan; Department of Cardiovascular Medicine, Shiga University of Medical Science, Otsu, Japan; Address for correspondence: Dr Yuichi Sawayama, Department of Cardiovascular Medicine, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama 7108602, Japan.Department of Cardiovascular Medicine, Kurashiki Central Hospital, Kurashiki, JapanDepartment of Cardiovascular Medicine, Kurashiki Central Hospital, Kurashiki, JapanDepartment of Cardiovascular Medicine, Kurashiki Central Hospital, Kurashiki, JapanDepartment of Cardiovascular Medicine, Kurashiki Central Hospital, Kurashiki, JapanDepartment of Cardiovascular Medicine, Kurashiki Central Hospital, Kurashiki, JapanDepartment of Cardiovascular Medicine, Kurashiki Central Hospital, Kurashiki, JapanDepartment of Cardiovascular Medicine, Kurashiki Central Hospital, Kurashiki, JapanDepartment of Cardiovascular Medicine, Kurashiki Central Hospital, Kurashiki, JapanDepartment of Cardiovascular Medicine, Shiga University of Medical Science, Otsu, JapanDepartment of Cardiovascular Medicine, Kurashiki Central Hospital, Kurashiki, JapanBackground: Intravascular imaging (IVI) complements coronary angiography and may help prevent coronary artery perforation (CAP) during percutaneous coronary intervention (PCI). Objectives: The authors evaluated whether IVI-guided PCI is associated with a lower risk of PCI-related CAP in a real-world cohort. Methods: This observational study analyzed consecutive PCI procedures from January 2006 to October 2023. The procedures were divided into 4 groups according to the year performed: 2006 to 2010 (P1), 2011 to 2015 (P2), 2016 to 2020 (P3), and 2021 to 2023 (P4). We evaluated the trend of IVI-guided PCI and the incidence of CAP. A mixed effects logistic model was employed to assess their relationship. Results: CAP occurred in 368 (1.6%) of 22,368 PCIs. IVI-guided PCI accounted for 63% of all cases, of which 95% were intravascular ultrasound procedures. From P1 to P3, the ratio of IVI-guided PCI increased linearly (P1: 30%, P2: 61%, P3: 93%, P4: 97%), while the incidence of CAP decreased (P1: 2.10%, P2: 1.74%, P3: 1.13%, P4: 1.18%). IVI-guided PCI showed a significant association with a lower risk of the overall incidence of CAP (adjusted OR: 0.78; 95% CI: 0.61-0.99; P = 0.047). This relationship was particularly significant for chronic total occlusion PCI (adjusted OR: 0.59; 95% CI: 0.43-0.80; P = 0.001) and PCI for moderate or severe calcification (adjusted OR: 0.50; 95% CI: 0.33-0.74; P = 0.001). Conclusions: IVI-guided PCI may help prevent PCI-related CAP, especially in the setting of chronic total occlusion PCI and PCI for moderate or severe calcification.http://www.sciencedirect.com/science/article/pii/S2772374724003508coronary artery perforationintravascular imagingpercutaneous coronary intervention |
| spellingShingle | Yuichi Sawayama, MD Kenta Sasaki, MD Narumi Taninobu, MD Akihiro Ikuta, MD Kohei Osakada, MD Shunsuke Kubo, MD Takeshi Tada, MD Yasushi Fuku, MD Hiroyuki Tanaka, MD Yoshihisa Nakagawa, MD Kazushige Kadota, MD The Effect of Intravascular Imaging-Guided Percutaneous Coronary Intervention on Coronary Artery Perforation JACC: Asia coronary artery perforation intravascular imaging percutaneous coronary intervention |
| title | The Effect of Intravascular Imaging-Guided Percutaneous Coronary Intervention on Coronary Artery Perforation |
| title_full | The Effect of Intravascular Imaging-Guided Percutaneous Coronary Intervention on Coronary Artery Perforation |
| title_fullStr | The Effect of Intravascular Imaging-Guided Percutaneous Coronary Intervention on Coronary Artery Perforation |
| title_full_unstemmed | The Effect of Intravascular Imaging-Guided Percutaneous Coronary Intervention on Coronary Artery Perforation |
| title_short | The Effect of Intravascular Imaging-Guided Percutaneous Coronary Intervention on Coronary Artery Perforation |
| title_sort | effect of intravascular imaging guided percutaneous coronary intervention on coronary artery perforation |
| topic | coronary artery perforation intravascular imaging percutaneous coronary intervention |
| url | http://www.sciencedirect.com/science/article/pii/S2772374724003508 |
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