Safety and Feasibility of Intravascular Ultrasound-Guided Robotic

PurposePrevious studies have demonstrated the benefit of intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) for preventing longitudinal geographic miss (LGM). However, it is yet unclear whether IVUS guidance is useful for robotic PCI (R-PCI). This retrospective observational study sought to compare expected stent landing positions between IVUS and angiography.MethodsA total of 58 consecutive patients with stable angina who underwent IVUS-guided R-PCI was enrolled. The stent landing position was angiographically marked using a balloon marker before stenting followed by measurements of the expected stent length using balloon pullback. Subsequently, pre-stenting IVUS was performed to determine stent landing. All pre-PCI IVUS images were assessed for lesion length and percent plaque volume (%PV) using both IVUS and angiographic marking. LGM was defined as a residual %PV > 50% at either the distal or proximal stent edge, any stent edge dissection, and/or additional stent deployment immediately after stenting. Major adverse cardiac events were assessed at the 6-month follow-up.ResultsThe included patients, 41 of whom were male, had an average age of 67.1 ± 10.1 years. IVUS guidance had significantly longer lesion lengths compared to angiographic marking. Based on IVUS-guided stent deployment, 9 cases exhibited LGM immediately after stenting. IVUS-marked landing points had a significantly smaller %PV and significantly larger LA compared to those for angiography. No adverse cardiac events were noted during the 6-month follow-up.ConclusionIVUS-guided R-PCI was safe and may be better at preventing LGM compared to angiography-guided R-PCI.