Enhanced Outcomes of Intravascular Ultrasound-Guided Versus Angiography-Guided Percutaneous Coronary Intervention in Coronary Heart Disease: A Randomized Clinical Study

Abstract

Objective

This study aimed to compare the clinical efficacy of intravascular ultrasound (IVUS)-guided versus coronary angiography (CAG)-guided percutaneous coronary intervention (PCI) in patients with coronary heart disease (CHD).

Methods

One hundred CHD patients were randomized into two groups. The control group (n = 50) underwent CAG-guided PCI, while the study group (n = 50) underwent IVUS examination following CAG and received IVUS-guided PCI. Evaluated outcomes included lesion characteristics, stent parameters, postoperative complications, major adverse cardiovascular events (MACE), and coronary restenosis.

Results

Following stent implantation, the minimal lumen diameter in the study group was wider than that in the control group, while the diameter stenosis and plaque burden were lower than those in the control group (P < .05). The maximum stent diameter, maximum balloon diameter for post-dilation, maximum balloon pressure, immediate postoperative minimum stent diameter, and minimum stent cross-sectional area in the study group were greater than those in the control group. Additionally, the stent placement success rate in the study group was higher than that in the control group (P < .05). There was no difference in postoperative complications between the two groups (P > .05). During one-year follow-up, the study group had lower incidence of MACE compared with the control group (P < .05). The incidence of stent restenosis in the study group was lower than that in the control group, but the difference was not statistically significant (P > .05).

Conclusion

Compared with CAG guidance alone, IVUS-guided PCI for CHD can effectively improve coronary blood flow, enhance stent implantation efficacy, and reduce MACE incidence.