"Complex Coronary Artery Disease Stent Procedures, Effective Use of 'Intravascular Imaging Equipment'"

Samsung Seoul Hospital Cardiovascular Medicine Interventional Procedure Team Research
Improved Patient Outcomes with Use of Imaging Equipment During Procedures

Using intravascular imaging devices during coronary artery disease stent procedures has been shown to improve patient outcomes.

The Interventional Cardiology Team at Samsung Medical Center recently announced at the American College of Cardiology Annual Scientific Session (ACC 23/WCC) that stent procedures guided by vascular imaging techniques (percutaneous coronary intervention) are effective for patients with coronary artery lesions, according to a report on the 7th.

Samsung Seoul Hospital Cardiovascular Intervention Team. [Photo by Samsung Seoul Hospital]

Stent procedures are a highly effective treatment method for patients with coronary artery disease. However, stent procedures are not easy for patients with complex coronary artery lesions. This is because high-level, high-risk procedures tailored to the characteristics of the lesions are required. Therefore, during the procedure, to assess the lesion status and optimize the stent procedure, intravascular imaging devices such as intravascular ultrasound (IVUS) or optical coherence tomography (OCT) are used in addition to angiography.

Although stent procedures using intravascular imaging devices have many advantages over those using angiography alone, it had not been confirmed whether the use of intravascular imaging devices improves post-procedural outcomes.

The research team conducted a randomized clinical trial involving 20 institutions in Korea, comparing the outcomes of stent procedures using intravascular imaging devices versus those not using them in 1,639 patients who visited for stent procedures on complex coronary artery lesions between May 2018 and May 2021.

About two years after the procedure, target vessel failure (cardiac death, myocardial infarction, repeat stent procedures) occurred in 9.2% of patients. By group, the procedure group using intravascular imaging devices had a 7.7% incidence, while the group using angiography alone had 12.3%, indicating that the group using intravascular imaging devices had a 36% lower risk of target vessel failure.

Adverse outcomes such as cardiac death, myocardial infarction, and repeat stent procedures occurred at rates of 1.7%, 3.7%, and 3.4% respectively in the group using intravascular imaging devices. In contrast, the group undergoing procedures with angiography alone had higher rates of 3.8%, 5.6%, and 5.5%. Notably, the risk of cardiac death was 53% lower in the group using intravascular imaging devices.

This study was the first to demonstrate that using intravascular imaging devices during stent procedures in patients with complex coronary artery lesions can improve patient outcomes, attracting significant attention in the academic community. The research results were simultaneously published in the March issue of the world-renowned journal New England Journal of Medicine (NEJM) alongside the presentation at the American College of Cardiology.

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