Valvular & structural heart disease
Intravascular Ultrasound Assessment of Coronary Arteries at High Risk for Obstruction Following Transcatheter Aortic Valve Replacement (TAVR): The ICARO Study
Authors' conclusion
This first multicenter investigation on the IVUS use in the setting of CAO during TAVR suggests that the technique is both feasible and safe.
Study context
- Population
- Native and valve-in-valve TAVR with ≥2 radiological predefined high-risk characteristics for coronary artery obstruction
- Participants
- 32 participants40 vessels
- Exposure
- Intravascular ultrasound (IVUS)-guided decision on chimney stenting after TAVR
- Stentsn = 16
- Deferredn = 16reference
- Outcome
- Feasibility and safety of IVUS assessment after TAVR
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
- Sudden coronary artery obstruction (CAO) requiring urgent chimney stenting before IVUS
- 2
Observational data: associations, not effects.
Secondary outcomes
Chimney stenting deferred after IVUS
- Chimney deferred
- 24 of 38 cases (63%; 95% CI: 50%-78.9%)
IVUS features guiding stenting
- Minimal cross-sectional area at the ostial-paraostial space and distance of the displaced leaflet from the coronary ostium
Safety
| Outcome | Deferred | Estimate | P value |
|---|---|---|---|
| MACCE · median follow-up 366 days (Q1-Q3: 119-780 days)Stented vs Deferred · did not differ | 6.2% | (95% CI 0%–15.6%) | P = 0.958 |
- MACCE: Stented 6.2%
Original publication
Intravascular Ultrasound Assessment of Coronary Arteries at High Risk for Obstruction Following TAVR: The ICARO Study. JACC Cardiovasc Interv. Published 12 May 2025. doi:10.
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