Viana Sidonio Mesquita, Zhang Dai-Min
Department of Cardiology, Sir Run Run Hospital, Nanjing Medical University, 211112 Nanjing, Jiangsu, China.
Rev Cardiovasc Med. 2024 Dec 18;25(12):443. doi: 10.31083/j.rcm2512443. eCollection 2024 Dec.
Intravascular ultrasound (IVUS) in percutaneous coronary intervention (PCI) has transformed the management of complex higher risk-indicated patients (CHIPs), representing a pivotal advancement in high-risk procedure navigation. IVUS, complementing conventional angiography, provides unparalleled insights into lesion characteristics, plaque morphology, and vessel structure, enhancing the precision of stent placement and postprocedural care for CHIPs. The ongoing trials underscore the pivotal role of IVUS in optimizing procedural accuracy and improving clinical outcomes for high-risk patients, promising exciting new findings. However, notable gaps persist, encompassing the absence of standardized IVUS protocols, cost implications, and limited integration into routine practice. This study aims to address these gaps comprehensively by further delineating the influence of IVUS on patient outcomes, procedural success, and long-term prognostic indicators. This review aims to provide a clear overview of IVUS-guided PCI in CHIP, highlighting the significance of ongoing trials, identifying prevalent challenges, and outlining the objective of narrowing these gaps.
血管内超声（IVUS）在经皮冠状动脉介入治疗（PCI）中改变了复杂高风险指征患者（CHIPs）的管理方式，代表了高风险手术导航方面的一项关键进展。IVUS作为传统血管造影的补充，能提供有关病变特征、斑块形态和血管结构的无与伦比的见解，提高了CHIPs支架置入的精准度和术后护理水平。正在进行的试验强调了IVUS在优化手术准确性和改善高危患者临床结局方面的关键作用，有望带来令人兴奋的新发现。然而，显著差距仍然存在，包括缺乏标准化的IVUS方案、成本影响以及在常规实践中的整合有限。本研究旨在通过进一步阐明IVUS对患者结局、手术成功和长期预后指标的影响来全面解决这些差距。本综述旨在清晰概述IVUS引导下的CHIPs PCI，强调正在进行的试验的重要性，识别普遍存在的挑战，并概述缩小这些差距的目标。
