<International Circulation>: Do you agree with the viewpoint that implanting DES under guidance of intravascular ultrasound (IVUS) can reduce the occurrence of stent thrombosis? And is it necessary or beneficial to use IVUS routinely for DES implantation?

    Dr Patel: My view is “yes”， but it is not based on evidence. The meta-analysis of available observational data may trend towards the belief that IVUS-guided therapy helps but there has not been a large randomized study to show routine implantation versus IVUS-guided implantation to prove the point. I suspect IVUS is a marker for the thoroughness of the procedure - so if you care enough to put IVUS down， if you care enough to look， care enough to post-dilate， if you care enough to take an extra moment to make sure the stent is fully apposed. Some of it is the technology; some of it is the operator. But my general sense is， in our lab， we ask that IVUS is performed post-intervention to guide how well the stent is apposed.

  《国际循环》：有人认为，IVUS引导下置入药物洗脱支架能够减少支架内血栓发生，您认同这一观点吗？置入药物洗脱支架时常规应用IVUS是否有必要？有没有益处？
    Patel教授：我认同这个观点，但是这并不是基于循证证据的。针对现有观察性数据的荟萃分析可能倾向于IVUS引导下置入药物洗脱支架会有益处，但是还没有大型随机试验来比较常规置入药物洗脱支架与IVUS引导下置入支架来证明这一观点。我觉得IVUS可使操作更完整。如果你注重看到血管壁的情况、关心球囊后扩张，如果你想要多花点儿时间看看支架是不是完全贴壁的话，可以应用IVUS。这与技术还有操作者都有关。但是在我所在的导管室，我通常要求大家在置入支架后使用IVUS来观察支架的贴壁情况。