Long-term safety of intravascular ultrasound in nontransplant, nonintervened, atherosclerotic coronary arteries.
OBJECTIVE
The goal of this study was to demonstrate that intravascular ultrasound (IVUS) examination of native coronary arteries does not result in an acceleration of the atherosclerotic process.


BACKGROUND
Intravascular ultrasound is increasingly used to assess the effects of pharmacologic agents on atherosclerosis.


METHODS
Intravascular ultrasound examinations of one coronary artery and coronary angiography were performed in 525 patients at baseline. Patients then underwent a follow-up angiogram 18 to 24 months later. All end points were evaluated in IVUS-related and non-IVUS arteries using quantitative coronary analysis. The study end points were the coronary change score (per-patient mean of minimum lumen diameter changes for all lesions measured), occurrence of new coronary lesions, and progression of preexistent lesions at follow-up. Acute angiographic and clinical complications were also analyzed.


RESULTS
Coronary change score was -0.06 +/- 0.23 mm and -0.05 +/- 0.21 mm for IVUS-related and non-IVUS arteries, respectively (p = 0.35). The increase in percent diameter stenosis from baseline to follow-up was 0.8 +/- 6.7% and 1.2 +/- 7.0% in the IVUS-related and non-IVUS arteries (p = 0.29). New lesions occurred in 3.6% and 3.9% of IVUS-related and non-IVUS arteries, respectively (p = 0.84). When all coronary lesions were considered, the incidence of lesion progression was not significantly different between IVUS-related (11.6%) and non-IVUS (9.8%) arteries. Coronary spasm occurred in 1.9% of IVUS procedures, and there was one case of acute occlusion with no long-term sequelae.


CONCLUSIONS
Intravascular ultrasound does not significantly accelerate atherosclerosis in native coronary arteries and can be used safely to assess progression/regression in clinical trials.
Guédès
Antoine
A
Research Center, Montreal Heart Institute, Montreal, Quebec, Canada.
Keller
Pierre-Frédéric
PF
L'Allier
Philippe L
PL
Lespérance
Jacques
J
Grégoire
Jean
J
Tardif
Jean-Claude
JC
D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012449:Safety; D013997:Time Factors; D018084:Ultrasonography, Interventional