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Comment & Response
June 14, 2016

Ultrasound vs Angiography for Drug-Eluting Stent Implantation—Reply

Author Affiliations
  • 1Division of Cardiology, Severance Cardiovascular Hospital, Seoul, Korea

Copyright 2016 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA. 2016;315(22):2469-2470. doi:10.1001/jama.2016.1382

In Reply In comparing the IVUS-guided with the angiography-guided strategy for drug-eluting stent optimization, different end points and methods of vessel diameter measurement were used, as noted by Dr Hoffer, due to the intrinsic difficulty in defining common optimization criteria for both groups. We think these differences are unlikely to explain the results. Previous studies, such as the Angiography Vs IVUS Optimization (AVIO) trial1 and a meta-analysis,2 also reported larger postintervention minimal lumen diameter and lesser residual stenosis with IVUS-guided drug-eluting stent implantation. However, in the AVIO trial, the greater minimal lumen diameter in the IVUS-guided group failed to lead to better clinical outcomes, unlike in our IVUS-XPL trial.