Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2025 Jul;40(3):516-526.
doi: 10.1007/s12928-025-01110-z. Epub 2025 Apr 6.

Complex PCI and 1-year outcomes in the OPTIVUS-complex PCI study multivessel cohort

Masaomi Gohbara  1 , Kiyoshi Hibi  2 , Takeshi Morimoto  3 , Hidekuni Kirigaya  1 , Ko Yamamoto  4 , Koh Ono  4 , Hiroki Shiomi  4 , Masanobu Ohya  5 , Kyohei Yamaji  4 , Hiroki Watanabe  6 , Tetsuya Amano  7 , Yoshihiro Morino  8 , Kensuke Takagi  9 , Junko Honye  10 , Hitoshi Matsuo  11 , Mitsuru Abe  12 , Kazushige Kadota  5 , Kenji Ando  13 , Koichi Nakao  14 , Shinjo Sonoda  15 , Satoru Suwa  16 , Kazuya Kawai  17 , Ken Kozuma  18 , Yoshihisa Nakagawa  19 , Yuji Ikari  20 , Mamoru Nanasato  21 , Keiichi Hanaoka  22 , Kengo Tanabe  23 , Yoshiki Hata  24 , Takashi Akasaka  25 , Takeshi Kimura  4 ; OPTIVUS-Complex PCI investigators
Affiliations
Multicenter Study

Complex PCI and 1-year outcomes in the OPTIVUS-complex PCI study multivessel cohort

Masaomi Gohbara et al. Cardiovasc Interv Ther. 2025 Jul.

Abstract

It remains unknown whether intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) can improve the clinical outcomes of complex PCI to a level equivalent to that of non-complex PCI. In the OPTIVUS-Complex PCI (Optimal Intravascular Ultrasound-Guided Complex PCI) Study multivessel cohort, a total of 1011 patients who underwent multivessel PCI involving a target lesion in the left anterior descending coronary artery (LAD) were divided into 2 groups: complex PCI (N = 760) and non-complex PCI groups (N = 251). Complex PCI was defined as a procedure with the following characteristics: 3 vessels treated, 3 stents implanted, 3 lesions treated, bifurcation with 2 stents implanted, total stent length > 60 mm, or target of chronic total occlusion. The primary endpoint was major adverse cardiac and cerebrovascular event (MACCE) defined by a composite of death, myocardial infarction, stroke, or any coronary revascularization. The cumulative 1-year incidences of the primary endpoint and any coronary revascularization were not significantly different between the complex and non-complex PCI groups (10.9% vs. 8.3%, P = 0.24, and 7.7% vs. 4.8%, P = 0.12, respectively). In the multivariable Cox proportional hazards models, there was no significant excess risk of the complex PCI group relative to the non-complex PCI group for the primary endpoint (HR, 1.35; 95%CI, 0.83-2.18; P = 0.22), or for any coronary revascularization (HR, 1.64; 95%CI, 0.87-3.06; P = 0.11). After optimal IVUS-guided multivessel PCI with a target lesion in the LAD, 1-year risk of MACCE or coronary revascularization in patients with complex PCI was numerically higher than that in patients with non-complex PCI.

Keywords: Complex; Drug-eluting stent; Intravascular ultrasound; Percutaneous coronary intervention.

PubMed Disclaimer

Conflict of interest statement

Declarations. Competing interests: Kiyoshi Hibi reports lecturer fees from Abbott Medical, Daiichi Sankyo, and Medtronic; research grants from the Research Institute for Production Development, Japan Medical Device Corporation; and scholarship funds from Abbott Medical and NIPRO. Takeshi Morimoto reports lecturer fees from AstraZeneca, Bristol-Myers Squibb, Daiichi Sankyo, Japan Lifeline, Kowa, Toray, and Tsumura; manuscript fees from Bristol-Myers Squibb and Kowa; and advisory boards of Novartis and Teijin. Kengo Tanabe reports honoraria from Abbott Medical, Boston Scientific, Japan Lifeline, Medtronic, Orbusneich and Terumo. Takeshi Kimura reports research grants from Abbott Medical and Boston Scientific; honoraria from Abbott Medical, Boston Scientific, Daiichi Sankyo, Sanofi, and Terumo; and participation on the advisory boards of Abbott Medical, Boston Scientific, and Sanofi. The authors have no conflicts of interest to declare. Ethics approval: This study was conducted in accordance with the Declaration of Helsinki and approved by the Kyoto University Certified Review Board and Ethics Committee (Y0011). Informed Consent: Written informed consent was provided from all enrolled patients.

References

    1. Fujimoto Y, Sakakura K, Fujita H. Complex and high-risk intervention in indicated patients (CHIP) in contemporary clinical practice. Cardiovasc Interv Ther. 2023;38:269–74. - DOI - PubMed
    1. Hoole SP, Bambrough P. Recent advances in percutaneous coronary intervention. Heart. 2020;106:1380–6. - DOI - PubMed
    1. Saito Y, Kobayashi Y, Fujii K, Sonoda S, Tsujita K, Hibi K, et al. CVIT 2023 clinical expert consensus document on intravascular ultrasound. Cardiovasc Interv Ther. 2023;2:9. https://doi.org/10.1007/s12928-023-00957-4 . - DOI
    1. Zhang J, Gao X, Kan J, Ge Z, Han L, Lu S, et al. Intravascular ultrasound versus angiography-guided drug-eluting stent implantation: the ULTIMATE trial. J Am Coll Cardiol. 2018;72:3126–37. - DOI - PubMed
    1. Lee JM, Choi KH, Song YB, Lee JY, Lee SJ, Lee SY, et al. Intravascular imaging-guided or angiography-guided complex PCI. N Engl J Med. 2023;388:1668–79. - DOI - PubMed

LinkOut - more resources