Intravascular imaging consistently improves PCI outcomes, new meta-analysis confirms
Percutaneous coronary intervention (PCI) procedures guided by intravascular imaging are associated with a significantly lower risk of adverse cardiovascular events than those guided by angiography, according to a new meta-analysis published in JACC.
Intravascular imaging has gained momentum in recent years, with both intravascular ultrasound (IVUS) and optical coherence tomography (OCT) being used more often to guide PCI. While many studies have highlighted the value of IVUS and OCT, others have failed to find a major benefit to using these modalities. To learn more, the team behind this study performed comprehensive meta-analysis comparing the use of intravascular imaging during PCI with traditional angiography guidance.
The researchers explored data from 28 different randomized trials. This included more than 24,000 patients with a mean age of 64.8 years old. Nearly 76% of patients were men, and the mean follow-up period was 21.6 months.
Overall, PCI guided by intravascular imaging—either IVUS or OCT—was linked to consistent reductions in target lesion failure, myocardial infarction, target lesion revascularization, stent thrombosis, cardiac mortality and all-cause mortality compared to angiography-guided PCI.
“Firm evidence for at least 20% reductions in all major outcomes was present despite the inclusion of several recent trials with neutral results, suggesting that the totality of evidence continues to support intravascular imaging-guided intervention,” wrote first author Sripal Bangalore, MD, an interventional cardiologist with NYU Langone Health, and colleagues.
The group added that both IVUS and OCT guidance were linked to these positive outcomes, and no significant differences between the modalities could be identified.
Finally, Bangalore et al. concluded that these results help make the case for intravascular imaging to be a “routine component of state-of-the-art PCI for the treatment of complex coronary artery disease.”
Click here to read the full analysis in JACC, an American College of Cardiology journal.
Michael has more than 19 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.