Safety and Effectiveness of Intracoronary Imaging-Guided PCI in Contemporary Practice: Insights From BMC2.
Document Type
Article
Publication Date
2025
Publication Title
Circulation. Cardiovascular Interventions
Abstract
BACKGROUND: Studies suggest percutaneous coronary intervention (PCI) guided by intracoronary imaging (ICI) results in larger balloon/stent diameters and longer stents. Whether this occurs in real-world PCI is poorly understood.
METHODS: De novo PCIs performed at 48 nonfederal Michigan hospitals between July 2019 and June 2022 were evaluated with regression modeling to evaluate associations between ICI-guided PCI and balloon/stent dimensions. The association between ICI-guided PCI and coronary dissection/perforation was assessed using adjusted odds ratios.
RESULTS: ICI was used in 16 777 (22.5%) PCI-treated lesions and increased from 11.2% of cases in July 2019 to 32.1% in June 2022. Compared with angiography alone, the average patient/procedural-adjusted treatment effect of ICI use included: +0.19 mm stent diameter (95% CI +0.16 to +0.22), +0.45 mm maximum balloon diameter (95% CI +0.40 to +0.51), and +3.51 mm stent length (95% CI +2.54 to +4.48). These findings persisted when controlling for the operator. ICI use was associated with a higher risk of dissections (adjusted odds ratio, 2.55 [95% CI, 2.05-3.16]) and perforations (adjusted odds ratio, 2.25 [95% CI, 1.74-2.91]); however, increased use of ICI and larger stent/balloon sizes over the study period (
CONCLUSIONS: In real-world practice, ICI-guided PCI was associated with larger stent/balloon diameters and longer stents. While ICI use was associated with dissections and perforations, there was no significant increase in the rate of these complications despite significant increases in ICI use and stent/balloon sizes during the study period. Further research is needed to evaluate the association between ICI use and procedural complications.
Volume
18
Issue
9
First Page
e014886
Last Page
e014886
Recommended Citation
Basala T, Seth M, Madder RD, Wanamaker B, Fuller B, Shlofmitz E, et al [Tucciarone M, Sukul D]. Safety and effectiveness of intracoronary imaging-guided PCI in contemporary practice: Insights from BMC2. Circ Cardiovasc Interv. 2025;18(9):e014886. doi: 10.1161/circinterventions.124.014886. PMID: 40827405.
DOI
10.1161/circinterventions.124.014886
ISSN
1941-7632
PubMed ID
40827405
Comments
Frederik Meijer Heart & Vascular Institute