IVUS as a Diagnostic Tool for Optimizing Coronary Stenting in High-Risk Lesions

Abstract

Objectives: To evaluate the efficacy of Intravascular Ultrasound (IVUS) in optimizing coronary stenting in high-risk lesions. This study specifically compared procedural outcomes and long-term complications between IVUS-guided and angiography-guided Percutaneous Coronary Interventions (PCI). Methodology: A retrospective analysis was conducted on 100 patients who underwent PCI at HMC Peshawar from January to December 2024. Among them, 50 patients received IVUS-guided PCI, and 50 underwent angiography-guided PCI. Data on demographics, procedural success, and long-term Major Adverse Cardiovascular Events (MACE) were collected. Statistical significance was assessed using the chi-square test. Results: The mean age was 60.4 ± 10.5 years, with 48% males and 52% females. IVUS-guided PCI achieved a significantly higher procedural success rate (86.0%) compared to the angiography-guided group (79.0%) (p = 0.026). The incidence of MACE was lower in the IVUS group (5%) compared to the angiography group (10%) (p = 0.045). No significant correlation was observed between patient age and the degree of stenosis. Conclusion: IVUS-guided PCI significantly enhances procedural success and reduces long-term complications compared to angiography-guided PCI. The findings support the use of IVUS as a valuable diagnostic and interventional tool for optimizing stent deployment in high-risk coronary lesions.