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Current use of intracoronary imaging in interventional practice – Results of a European Association of Percutaneous Cardiovascular Interventions (EAPCI) and Japanese Association of Cardiovascular Interventions and Therapeutics (CVIT) Clinical Practice Survey

1. Department of Cardiology, Bern University Hospital, Switzerland; 2. Toho University, Ohashi Medical Center, Tokyo, Japan; 3. Deutsches Herzzentrum München, Technische Universität München, Munich, Germany; 4. Kurashiki Central Hospital, Kurashiki, Japan; 5. Ferrarotto Hospital, University of Catania, Catania, Italy; 6. The Lambe Institute for Translational Medicine and Curam Saolta University Healthcare Group, Galway, Ireland; 7. Wakayama Medical University, Wakayama, Japan; 8. Interventional Cardiology Unit, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy; 9. DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany

Aims: This study evaluated the views of the cardiology community on the clinical use of coronary intravascular imaging (IVI).

Methods and results: A web-based survey was distributed to 31,893 individuals, with 1,105 responses received (3.5% response rate); 1,010 of 1,097 respondents (92.1%) self-reported as interventional cardiologists, 754 (68.7%) with >10 years experience. Overall, 96.1% had personal experience with IVI (95.5% with intravascular ultrasound [IVUS], 69.8% with optical coherence tomography [OCT], and 7.9% with near-infrared spectroscopy); 34.7% of respondents were from Europe and 52.0% were from Asia (45.4% from Japan). The most commonly reported indications for IVI were optimization of stenting (88.5%), procedural/strategy guidance (79.6%), and guidance of left main interventions (77.0%). Most respondents reported perceived equipoise regarding choice between IVUS and OCT for guidance of coronary intervention. High cost (65.9%) and prolongation of the procedure (35.0%) were the most commonly reported factors limiting use. IVI was used more frequently (>15% of cases guided by IVI) in Japan than Europe (96.6% vs. 10.4%, respectively; P<0.001) and by operators with longer interventional experience.

Conclusions: In a sample of predominantly experienced interventional cardiologists, there was a high rate of personal experience with IVI in clinical practice. The most commonly identified indications for IVI were optimization of stenting, procedural/strategy guidance, and guidance of left main interventions. Variability in practice patterns is substantial according to geographic region and interventional experience.

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