Feasibility and safety of intracoronary ultrasound. Single center experience

Background and objectives. Intracoronary ultrasound provides a number of ad vantages in the quantification and characterization of coronary stenoses wi th regard to contrast angiography. However, previous studies have reported a 3.5 to 11% complication rate, and a 10-30% failure rate in performing thi s technique. The purpose of the study is to analyze the feasibility of perf orming intracoronary ultrasound and the incidence of complications associat ed with the use of contemporary, state of the art equipment. Material and methods. The feasibility of performing intracoronary ultrasoun d, analyzed as the percentage of successes and failures in performing the e xamination was reviewed, as well as the complication rate associated with t he technique in all the procedures carried out between July 1, 1994 and Feb ruary 29, 1996 in which intravascular ultrasound was attempted. Complicatio ns were categorized as related, non-related and uncertainly related to the ultrasound study. Results. 239 vessels were studied with intravascular ultrasound in 209 proc edures (74% interventional) performed on 139 patients. Ultrasound examinati on was feasible in all the diagnostic studies and in 96% of the interventio nal procedures. The major and minor procedural complication rate was 2.4 an d 10.5% respectively. No major complication was related to the ultrasound e xamination. Three patients experienced minor complications (1.4%) related t o the ultrasound study. All three complications occurred in baseline studie s during interventional procedures. Conclusions. Intracoronary ultrasound is feasible and safe in the vast majo rity of the procedures. Improvements in smaller catheter size and design an d larger operator expertize have significantly reduced the complication rat e, particularly the most frequent coronary spasm so far. Complications are associated with baseline studies during interventional procedures and with less operator expertize.