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Long-term clinical outcomes of intravascular imaging-guided percutaneous coronary intervention versus angiography-guided percutaneous coronary intervention in complex coronary lesions: a systematic review and meta-analysis

    Danish Ali Ashraf

    *Author for correspondence: Tel.: +92 335 622 3364;

    E-mail Address: danishaliashraf07@outlook.com

    Department of Internal Medicine, Foundation University Medical College, Islamabad, 44000, Pakistan

    ,
    Usman Ahmed

    Department of Internal Medicine, Rawalpindi Medically University, Rawalpindi, 46000, Pakistan

    ,
    Zainab Zaib Khan

    Department of Internal Medicine, CMH Lahore Medical & Dental College, Lahore, 54810, Pakistan

    ,
    Fiza Mushtaq

    Department of Internal Medicine, Allama Iqbal Medical College, Lahore, 54700, Pakistan

    ,
    Shehar Bano

    Department of Internal Medicine, Gujranwala Medical College, Gujranwala, 52250, Pakistan

    ,
    Ali Raza Khan

    Department of Internal Medicine, Nishtar Medical University, Multan, 66000, Pakistan

    ,
    Saad Azam

    Department of Internal Medicine, Shaikh Khalifa Bin Zayed Al Nahyan Medical & Dental College, Lahore, 64260, Pakistan

    ,
    Abdullah Haroon

    Department of Internal Medicine, Ziauddin Medical College, Karachi, 75600, Pakistan

    ,
    Salman Ahmed Malik

    Department of Internal Medicine, Nishtar Medical University, Multan, 66000, Pakistan

    ,
    Raza Aslam

    Department of Internal Medicine, Nishtar Medical University, Multan, 66000, Pakistan

    ,
    Jai Kumar

    Department of Internal Medicine, Wayne State School of Medicine, Detroit, MI 48201, USA

    ,
    Farva Zaib Khan

    Department of Internal Medicine, Al-Nafees Medical College, Islamabad, 44000, Pakistan

    ,
    Amna Faheem

    Department of Internal Medicine, Abbottabad Int. Medical College, Abbottabad, Pakistan

    ,
    Sarwan Kumar

    Department of Internal Medicine, Wayne State School of Medicine, Detroit, MI 48201, USA

    &
    Saad Hassan

    Department of Internal Medicine, Foundation University Medical College, Islamabad, 44000, Pakistan

    Published Online:https://doi.org/10.2217/fca-2023-0124

    Background: In this study, we aim to discuss the long-term clinical outcomes of intravascular ultrasound imaging-guided percutaneous intervention (IVUS-PCI) versus angiography-guided percutaneous coronary intervention (PCI) in complex coronary lesions over a mean period of 2 years. Methods: A systematic search and meta-analysis were conducted to assess the efficacy of using intravascular ultrasound or optical coherence tomography guidance in coronary artery stenting compared to angiography. Results: A total of 11 randomized controlled trials with 6740 patients were included. For the primary outcome, a pooled analysis (3.2 vs 5.6%). For secondary outcomes, the risk was significantly low in image-guided percutaneous intervention compared with angiography. Conclusion: Intravascular imaging-guided PCI is significantly more effective than angiography-guided PCI in reducing the risk of target lesion revascularization, target vessel revascularization, cardiac death, major adverse cardiovascular events and stent thrombosis.

    Tweetable abstract

    A meta-analysis was conducted to compare intravascular ultrasound guidance/optical coherence tomography percutaneous coronary intervention with angiography percutaneous coronary intervention with target lesion revascularization as the primary outcome and target vessel revascularization, stent thrombosis, myocardial infarction, major adverse cardiovascular events, all cause death and cardiac death as the secondary outcomes.

    Papers of special note have been highlighted as: • of interest; •• of considerable interest

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