Enhancing Coronary Intervention Outcomes Using Intravascular Ultrasound: Analysis of Long-Term Benefits in a Japanese Multicenter Registry

•IVUS is underutilized for PCI while a high proportion of patients undergo IVUS.•We assessed the association between IVUS and long-term outcomes in Japan.•We analyzed 8721 consecutive patients with 83.8% of IVUS-guided PCI.•After adjustments, the IVUS group had lower rates of death and coronary bypass.•The effect was more prominent in complex coronary artery disease.