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Clinical and Procedural Outcomes of IVUS-Guided vs. Angiography-Guided CTO-PCI: A Systematic Review and Meta-Analysis
by
Abdelwahed, Youssef S.
, Torella, Daniele
, Salerno, Nadia
, Panuccio, Giuseppe
, Werner, Gerald S.
, Carabetta, Nicole
, Leistner, David Manuel
, Landmesser, Ulf
, De Rosa, Salvatore
in
Angiography
/ Cardiovascular disease
/ Care and treatment
/ Clinical medicine
/ Clinical outcomes
/ Coronary heart disease
/ Coronary vessels
/ Heart attacks
/ Intravascular ultrasonography
/ Medical imaging
/ Meta-analysis
/ Methods
/ Mortality
/ Observational studies
/ Patient outcomes
/ Stents
/ Systematic Review
/ Thrombosis
/ Transluminal angioplasty
2023
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Clinical and Procedural Outcomes of IVUS-Guided vs. Angiography-Guided CTO-PCI: A Systematic Review and Meta-Analysis
by
Abdelwahed, Youssef S.
, Torella, Daniele
, Salerno, Nadia
, Panuccio, Giuseppe
, Werner, Gerald S.
, Carabetta, Nicole
, Leistner, David Manuel
, Landmesser, Ulf
, De Rosa, Salvatore
in
Angiography
/ Cardiovascular disease
/ Care and treatment
/ Clinical medicine
/ Clinical outcomes
/ Coronary heart disease
/ Coronary vessels
/ Heart attacks
/ Intravascular ultrasonography
/ Medical imaging
/ Meta-analysis
/ Methods
/ Mortality
/ Observational studies
/ Patient outcomes
/ Stents
/ Systematic Review
/ Thrombosis
/ Transluminal angioplasty
2023
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Clinical and Procedural Outcomes of IVUS-Guided vs. Angiography-Guided CTO-PCI: A Systematic Review and Meta-Analysis
by
Abdelwahed, Youssef S.
, Torella, Daniele
, Salerno, Nadia
, Panuccio, Giuseppe
, Werner, Gerald S.
, Carabetta, Nicole
, Leistner, David Manuel
, Landmesser, Ulf
, De Rosa, Salvatore
in
Angiography
/ Cardiovascular disease
/ Care and treatment
/ Clinical medicine
/ Clinical outcomes
/ Coronary heart disease
/ Coronary vessels
/ Heart attacks
/ Intravascular ultrasonography
/ Medical imaging
/ Meta-analysis
/ Methods
/ Mortality
/ Observational studies
/ Patient outcomes
/ Stents
/ Systematic Review
/ Thrombosis
/ Transluminal angioplasty
2023
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Clinical and Procedural Outcomes of IVUS-Guided vs. Angiography-Guided CTO-PCI: A Systematic Review and Meta-Analysis
Journal Article
Clinical and Procedural Outcomes of IVUS-Guided vs. Angiography-Guided CTO-PCI: A Systematic Review and Meta-Analysis
2023
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Overview
Chronic total occlusions (CTO) in coronary angiographies present a significant challenge nowadays. Intravascular ultrasound (IVUS) is a valuable tool during CTO-PCI, aiding in planning and achieving procedural success. However, the impact of IVUS on clinical and procedural outcomes in CTO-PCI remains uncertain. This meta-analysis aimed to compare IVUS-guided and angiography-guided approaches in CTO-PCI. The study included five studies and 2320 patients with stable coronary artery disease (CAD) and CTO. The primary outcome of major adverse cardiac events (MACE) did not significantly differ between the groups (p = 0.40). Stent thrombosis was the only secondary clinical outcome that showed a significant difference, favoring the IVUS-guided approach (p = 0.01). Procedural outcomes revealed that IVUS-guided procedures had longer stents, larger diameters, and longer procedure and fluoroscopy times (p = 0.007, p < 0.001, p = 0.03, p = 0.002, respectively). Stent number and contrast volume did not significantly differ between the approaches (p = 0.88 and p = 0.33, respectively). In summary, routine IVUS use did not significantly improve clinical outcomes, except for reducing stent thrombosis. Decisions in CTO-PCI should be individualized based on patient characteristics and supported by a multi-parametric approach.
Publisher
MDPI AG,MDPI
Subject
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