Intravascular Ultrasound Guided Intervention in Calcified Coronary Lesions Showed Good Clinical Outcomes during One Year Follow-Up

Khanh-Hung Doan; Tai-Li Liu; Won-Sik Yun; Yi-Sik Kim; Kyeong Ho Yun; Seok Kyu Oh; Jong-Pil Park; Jay Young Rhew; Sang-Rok Lee

doi:10.3390/jcm12124073

Intravascular Ultrasound Guided Intervention in Calcified Coronary Lesions Showed Good Clinical Outcomes during One Year Follow-Up

J Clin Med. 2023 Jun 15;12(12):4073. doi: 10.3390/jcm12124073.

Authors

Khanh-Hung Doan¹, Tai-Li Liu¹, Won-Sik Yun¹, Yi-Sik Kim¹, Kyeong Ho Yun², Seok Kyu Oh², Jong-Pil Park³, Jay Young Rhew³, Sang-Rok Lee^{1

4}

Affiliations

¹ Division of Cardiology, Jeonbuk National University Hospital, Jeonju 54907, Republic of Korea.
² Division of Cardiology, Wonkwang University Hospital, Iksan 54538, Republic of Korea.
³ Division of Cardiology, Presbyterian Medical Center, Jeonju 54987, Republic of Korea.
⁴ Research Institute of Clinical Medicine, Jeonbuk National University Hospital, Jeonbuk National University Medical School, Jeonju 54907, Republic of Korea.

Abstract

Background: Calcified coronary lesions can cause stent under-expansion, malapposition, and polymer degradation, hence increasing the risk of adverse clinical outcomes. Percutaneous coronary intervention (PCI) guided by intravascular ultrasound (IVUS) has been used regularly to improve outcomes. Our primary aim was to evaluate the clinical efficacy of IVUS-guided PCI in calcified coronary lesions.

Methods: From August 2018 to December 2021, we prospectively included 300 patients in the CAPIRO study (CAlcified plaque in patients receiving Resolute Onyx^®) at three educational hospitals in Jeonbuk Province. We studied 243 patients (265 lesions) who were followed up for over a year. Based on coronary calcification by IVUS analysis, the patient population was categorized into two groups (Group I: non/mild calcification; Group II: moderate/severe calcification (maximum calcium arc >180° and calcium length > 5 mm)). One-to-one Propensity Score Matching was used to match the baseline characteristics. The stent expansion rate was analyzed by recent criteria. The primary clinical outcome was Major Adverse Cardiac Events (MACE), which included Cardiac death, Myocardial Infarction (MI), and Target Lesion Revascularization (TLR).

Results: After follow-up time, the MACE rate in Group I was 1.99%, comparable to Group II's 1.09% (p = 0.594). The components of MACE did not significantly differ between the two groups. Based on absolute MSA or MSA/MVA at MSA site criteria, the stent expansion rate in Group II was lower than that of Group I. Nevertheless, based on recent relative criteria, the stent expansion rate in both groups was comparable.

Conclusions: After more than a year of follow-up, IVUS-guided PCI in moderate/severe calcification lesions was associated with good clinical outcomes, which was comparable with non/mild calcification lesions. Future studies with a larger sample size and a more extended follow-up period are required to clarify our findings.

Keywords: calcium; drug-eluting stents; intravascular ultrasound; percutaneous coronary intervention.

Grants and funding

This research received no external funding.