Intravascular Ultrasound Imaging During Aortoiliac Stenting: No Impact on Outcomes at 1 Year. (February 2021)

• Record Type: Journal Article
• Authors: Tsujimura, Takuya; Takahara, Mitsuyoshi; Iida, Osamu; Yamauchi, Yasutaka; Shintani, Yoshiaki; Sugano, Teruyasu; Yamamoto, Yoshito; Kawasaki, Daizo; Yokoi, Hiroyoshi; Miyamoto, Akira; Mano, Toshiaki; Nakamura, Masato
• Is Part Of: Journal of endovascular therapy. Volume 28:Number 1(2021)
• Page Start: 139
• Page End: 145
• Publication Date: 2021-02
• Subjects: aortoiliac vessels -- endovascular treatment/therapy -- iliac artery -- intravascular ultrasound -- restenosis -- stent; Blood-vessels -- Endoscopic surgery -- Periodicals; Angioscopy -- Periodicals; Intravenous catheterization -- Periodicals; Peripheral vascular diseases -- Treatment -- Periodicals; Vascular Surgical Procedures -- Periodicals; Angioscopy -- Periodicals; Catheterization, Peripheral -- Periodicals; Peripheral Vascular Diseases -- therapy -- Periodicals; Angioscopie; Maladies vasculaires périphériques; 617.413
• DOI: 10.1177/1526602820949872
• Languages: English
• ISSNs: 1526-6028

Abstract

Purpose: To investigate the effect of intravascular ultrasound (IVUS) imaging use on clinical outcomes after aortoiliac stenting in patients with peripheral artery disease (PAD). Materials and Methods: Subjects for this retrospective analysis were derived from the OMOTENASHI registry database, which contained 803 symptomatic PAD patients (Rutherford categories 2–4) who were treated with self-expanding stent implantation for aortoiliac atherosclerotic lesions at 61 centers in Japan between January 2014 and April 2016. Of the 803 patients, 545 (67.9%) patients (mean age 73±9 years; 453 men) underwent IVUS-supported stent implantation and were compared with the 258 patients (mean age 73±8 years; 217 men) treated without IVUS. A propensity score analysis of 138 matched pairs was conducted to compare treatment strategies and clinical outcomes between patients having IVUS-supported endovascular therapy and those treated without IVUS. Results: Endovascular strategies and postoperative medications were not significantly different between the IVUS and no-IVUS groups. A procedure time under 1 hour was less frequent in the IVUS group, which had a longer fluoroscopy time. The 12-month restenosis rate was not significantly different between the 2 groups [10.2% (95% CI 6.9 to 14.9%) vs 10.3% (95% CI 5.4 to 18.6%), p=0.99]. There was no interaction between baseline characteristics and the association of IVUS use with restenosis risk. Conclusion: Propensity score matching analysis revealed that duration and fluoroscopy time during IVUS-supported procedures were significantly longer than in cases without IVUS use, whereas the 12-month restenosis rate was not significantly different between the groups. IVUS use in aortoiliac lesions may be unnecessary.