AUTHOR=Blessing Recha , Buono Andrea , Ahoopai Majid , Geyer Martin , Knorr Maike , Brandt Moritz , Steven Sebastian , Drosos Ioannis , Muenzel Thomas , Wenzel Philip , Gori Tommaso , Dimitriadis Zisis 

TITLE=Use of intravascular ultrasound for optimal vessel sizing in chronic total occlusion percutaneous coronary intervention

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.922366

DOI=10.3389/fcvm.2022.922366

ISSN=2297-055X

ABSTRACT=Aim: The aim of this study is to provide evidence how a standardized intravascular ultrasound (IVUS) use impacts stent size choice in the setting of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) compared to visual estimation.
Methods and results: Data of 82 consecutive patients who had successfully undergone IVUS-guided revascularization of a CTO at the University Medical Center Mainz were analyzed. Angiography-based stent size prediction for the proximal and distal vessel were compared to the implanted stent diameter after IVUS assessment. 
Angiography-based stent size prediction for the proximal vessel was 3.09±0.41whereas IVUS use demonstrated larger vessel diameter, resulting in a larger implanted stent diameter (3.24± 0.45, p < 0.001).  Proximal vessel stent size prediction was underestimated in the majority of patients by angiographic estimation. 
Angiography-based stent size prediction for the distal vessel was 2.79±0.38 whereas IVUS use demonstrated larger vessel diameter, resulting in a larger implanted stent diameter (2.92±0.39 p < 0.001).
Conclusions: Pre-Stent IVUS assessment in CTO PCI provides important information of  vessel morphology and size. Angiography-based stent size prediction for the proximal and the distal vessel was frequently underestimated, IVUS use demonstrated larger vessel diameter, resulting in significant larger implanted stent diameters.