Final results of the Can Routine Ultrasound Influence Stent Expansion (CRUISE) study.

Area of Science:

• Interventional Cardiology
• Medical Imaging
• Vascular Surgery

Background:

• Intravascular ultrasound (IVUS) offers superior stent geometry assessment compared to angiography.
• Studies link IVUS-measured stent expansion to improved clinical outcomes.
• The benefit of routine IVUS guidance over angiography alone for stent implantation remains unclear.

Purpose of the Study:

• To evaluate the impact of IVUS guidance on stent deployment in the high-pressure stenting era.
• To compare clinical outcomes between IVUS-guided and angiography-guided stent implantation.

Main Methods:

• The CRUISE study prospectively assigned centers to IVUS or angiography guidance.
• 525 patients underwent stent implantation with quantitative coronary angiography and IVUS.
• Clinical events were adjudicated at 9-month follow-up for 499 patients.

Main Results:

• The IVUS-guided group showed significantly larger minimal lumen diameter (P<0.001) and minimal stent area (P<0.001).
• Target vessel revascularization occurred less frequently in the IVUS-guided group (8.5% vs. 15.3%, P<0.05).
• A 44% relative reduction in target vessel revascularization was observed with IVUS guidance.

Conclusions:

• Ultrasound guidance may lead to more effective stent expansion than angiography alone.
• IVUS guidance appears to improve clinical outcomes by reducing revascularization rates.
• Routine IVUS guidance is a promising strategy for optimizing stent implantation.