Abstract 21351: Intravascular Ultrasound-Guided vs. Angiography-Guided Intervention in Coronary CTO: Report From a Seven Year National Data

Background: Intravascular ultrasound (IVUS) has been used for a long time to guide percutaneous coronary intervention in different subsets of coronary lesions and could be used to navigate guidewire within the CTO segment. However, previously published national data demonstrating the role of IVUS in CTO appears sparse. Methods: HCUP’s Nationwide Inpatient Sample (NIS) database from 2008-2014 was utilized to identify CTO (414.2), IVUS (00.24) and PCI using appropriate ICD-9 codes. Logistic regression analysis was used to adjust for confounders for our outcome variable of inpatient mortality. Result: 878112 CTO admissions were identified during study period, of which 47.6% went for revascularization with PCI (26.7% female, 69.8% white, and 51.1% age ≥ 65). IVUS was used in 5.4 %(22730) of these CTO PCI. Univariate anlaysis revealed significantly different distribution of baseline risk factors (Table 1a). In hospital mortality was lower (1.86% vs 2.99%, p<0.0001) in IVUS group. Cost of care was higher in IVU...