Intravascular Ultrasound-Guided Percutaneous Coronary Intervention for Severely Calcified Lesions Requiring Rotational Atherectomy

BACKGROUND AND OBJECTIVES: Intravascular ultrasound (IVUS) is an invaluable tool for accurate lesion assessment and optimal stent implantation during complex coronary interventions. This study evaluated the impact of IVUS guidance on the long-term clinical outcomes of patients undergoing percutaneous coronary intervention (PCI) for severely calcified lesions requiring rotational atherectomy (RA). METHODS: Between January 2010 and October 2019, 511 patients from nine tertiary centers in South Korea who underwent PCI with RA using second-generation drug-eluting stents were enrolled. The primary endpoint was a composite of cardiac death or myocardial infarction (MI). RESULTS: IVUS was performed in 241 (47.2%) patients. Compared with the angiography-guided PCI (A-GP) group, the IVUS-guided PCI (I-GP) group had a higher prevalence of the left main disease (23.7% vs. 5.9%; p