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
Meta-Analysis
. 2022 Jul 23;22(1):327.
doi: 10.1186/s12872-022-02772-w.

Efficacy of intravascular imaging-guided drug-eluting stent implantation: a systematic review and meta-analysis of randomized clinical trials

Ying Niu #  1 , Nan Bai #  1 , Ying Ma #  1 , Peng-Yu Zhong #  1 , Yao-Sheng Shang #  1 , Zhi-Lu Wang  2
Affiliations
Meta-Analysis

Efficacy of intravascular imaging-guided drug-eluting stent implantation: a systematic review and meta-analysis of randomized clinical trials

Ying Niu et al. BMC Cardiovasc Disord. .

Abstract

Background: Traditional angiography only displays two-dimensional images of the coronary arteries during stent implantation. However, intravascular imaging can show the structure of the vascular wall, plaque characteristics. This article aims to evaluate the efficacy of intravascular imaging-guided drug-eluting stent (DES) implantation.

Method: We conducted a systematic review and meta-analysis of randomized controlled trials of intravascular imaging-guided, including patients with DES implantation guided by intravascular ultrasound or optical coherence tomography and traditional angiography. The databases of PubMed, EMBASE, web of science, and Cochrane Library were searched. The primary outcome was target lesion revascularization (TLR). The secondary outcomes included the target vessel revascularization (TVR), myocardial infarction (MI), stent thrombosis (ST), cardiac death, all-cause death, and the major adverse cardiac events (MACE) during the 6-24 months follow-up. The fixed-effects model was used to calculate the relative risk (RR) and 95% confidence interval of the outcome event. Meanwhile, the trial sequence analysis was employed to evaluate the results.

Result: This meta-analysis included fourteen randomized controlled trials with 7307 patients. Compared with angiography-guided, intravascular imaging-guided DES implantation can significantly reduce the risk of TLR (RR 0.63, 0.49-0.82, P = 0.0004), TVR (RR 0.66, 0.52-0.85, P = 0.001), cardiac death (RR 0.58; 0.38-0.89; P = 0.01), MACE (RR 0.67, 0.57-0.79; P < 0.00001) and ST (RR 0.43, 0.24-0.78; P = 0.005). While there was no significant difference regarding MI (RR 0.77, 0.57-1.05, P = 0.10) and all-cause death (RR 0.87, 0.58-1.30, P = 0.50).

Conclusions: Compared with angiography, intravascular imaging-guided DES implantation is associated with better clinical outcomes in patients with coronary artery disease, especially complex lesions (Registered by PROSPERO, CRD 42021289205).

Keywords: DES; Intravascular imaging; Intravascular ultrasound; Meta-analysis; Optical coherence tomography.

PubMed Disclaimer

Conflict of interest statement

The author declares that there are no competing interests regarding the publication of this article.

Figures

Fig. 1
Fig. 1
Flow diagram of literature search
Fig. 2
Fig. 2
Comparison of the primary outcome between intravascular imaging and angiography guided coronary stent implantation
Fig. 3
Fig. 3
Comparison of the secondary outcome between intravascular imaging and angiography guided coronary stent implantation
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Balakumar P, Maung-U K, Jagadeesh G. Prevalence and prevention of cardiovascular disease and diabetes mellitus. Pharmacol Res. 2016;113(Pt A):600–609. doi: 10.1016/j.phrs.2016.09.040. - DOI - PubMed
    1. Shammas NW, Radaideh Q, Shammas WJ, et al. The role of precise imaging with intravascular ultrasound in coronary and peripheral interventions. Vasc Health Risk Manag. 2019;7(15):283–290. doi: 10.2147/VHRM.S210928. - DOI - PMC - PubMed
    1. Waldo SW, Gokhale M, O'Donnell CI, et al. Temporal trends in coronary angiography and percutaneous coronary intervention: insights from the VA clinical assessment, reporting, and tracking program. JACC Cardiovasc Interv. 2018;11(9):879–888. doi: 10.1016/j.jcin.2018.02.035. - DOI - PubMed
    1. Hoang V, Grounds J, Pham D, et al. The role of intracoronary plaque imaging with intravascular ultrasound, optical coherence tomography, and near-infrared spectroscopy in patients with coronary artery disease. Curr Atheroscler Rep. 2016;18(9):57. doi: 10.1007/s11883-016-0607-0. - DOI - PubMed
    1. Levine GN, Bates ER, Blankenship JC, et al. 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention: executive summary: a report of the American college of cardiology foundation/American heart association task force on practice guidelines and the society for cardiovascular angiography and interventions. Circulation. 2011;124(23):2574–2609. doi: 10.1161/CIR.0b013e31823a5596. - DOI - PubMed

MeSH terms