Short-term Clinical Outcomes at Patients Undergoing Percutaneous Coronary Revascularization of Chronic Total Occlusion: A Comparative Study Between Intravascular Ultrasound-guided versus Angiography-guided Intervention

Background: In order to learn about the characteristics of the lesion before the intervention, intravascular ultrasonography (IVUS) is a helpful tool during percutaneous coronary intervention (PCI). The capacity to characterize the morphology of intracoronary plaques and direct interventions has been greatly improved by this method. Aim: In this randomized controlled trial of chronic total occlusion (CTO) percutaneous revascularization, the researchers compared the short-term clinical results of intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) to those of angiography-guided PCI. Methods: Ninety patients, ranging in age from 18 to 80 years old and of both sexes, with a CTO duration of three months or more, were included in this comparative observational cohort study. Two groups of patients were formed: A total of 30 patients were enrolled in the IVUS-guided CTO revascularization group, while 60 patients were enrolled in the angiographic-guided PCI group. Results: The J-CTO score, retrograde approach, blunt cap, calcification, CTO length>20 mm, tortuosity-bent >45◦, fluoroscopy time, and number of stents did not substantially differ between groups. Compared to group II, group I had considerably longer procedural duration, max stent diameter, and length (P Conclusions: There is no difference in short term clinical outcomes or MACE between two groups however IVUS guidance for CTO PCI was associated with higher procedural time, max stent diameter, length and lower bilateral injections compared to angiography guidance alone. Also, IVUS guidance and angiography guidance were comparable regarding calcification, fluoroscopy time, number of stents, radiation DAP, and contrast volume.