101. Efficacy of intravascular imaging-guided stent implantation: A systematic review and meta-analysis of randomized clinical trials
- Author
-
Ying Niu, Nan Bai, Ying Ma, Peng-Yu Zhong, Yao-Sheng Shang, and Zhi-Lu Wang
- 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 stent implantation.Method: We conducted a systematic review and meta-analysis of randomized controlled trials of intravascular imaging-guided, including patients with stent implantation guided by intravascular ultrasound (IVUS) or optical coherence tomography (OCT) 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 (CI) of the outcome event. Meanwhile, the trial sequence analysis was employed to evaluate the results.Result: This meta-analysis included eighteen randomized controlled trials with 10413 patients. Compared with angiography-guided stent implantation, intravascular imaging-guided stent implantation can significantly reduce the risk of TLR (RR 0.62, 0.49-0.77, P<0.0001), TVR (RR 0.65, 0.52-0.81, P = 0.0001), cardiac death (RR 0.59; 0.39-0.91; P =0.02) , ST (RR 0.54, 0.30-0.97; P = 0.04) and MACE (RR 0.81, 0.71-0.93; P = 0.003), while there was no significant difference regarding MI (RR 0.78, 0.61-1.00, P = 0.05) and all-cause death (RR 0.85, 0.58-1.27, P = 0.44).Conclusions: Compared with angiography, intravascular imaging-guided stent implantation is associated with better clinical outcomes in patients with coronary artery disease (Registered by PROSPERO, CRD 42021289205).
- Published
- 2022
- Full Text
- View/download PDF