The use of intravascular ultrasound (IVUS) during percutaneous coronary intervention does not reduce all cause in-hospital mortality but doubles the cost with higher utilization in privately insured patients

Background The effect of using intravascular ultrasound (IVUS) during percutaneous coronary intervention (PCI) on short-term mortality is not well established. The goal of this study was to evaluate any association between the use of IVUS during PCI on mortality vs no ICUC in a large inpatient database. Method We used the National Inpatient Sample (NIS) database for available ICD-10 codes from 2016-2020 for IVUS and PCIs. Results A total of 10,059,56 PCIs were performed. 206,910 underwent IVUS-guided PCI vs 9,852,359 without IVUS use. Mortality did not differ between the two groups with 2.52% mortality in the IVUS arm vs 2.59% in no IVUS cohort, p=0.4. The mean age of patients with ICUS use was 65.5 vs 70.1 years without IVUS. Total in-hospital cost in the IVUS group was double that without IVUS (141,920$ vs 71,568$). Furthermore, IVUS utilization was significantly higher in patients with private HMO patients (28.3% vs 17.2%). Conclusion In-patient all-cause mortality using IVUS during PCI was similar to those patients without IVUS utilization but doubled the cost with higher utilization in privately insured patients