Intravascular imaging-guided versus angiography-guided percutaneous coronary intervention: a systematic review and meta-analysis of randomized controlled trials
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Background/Objectives: Despite the potential benefits, intravascular imaging for guiding percutaneous coronary intervention (PCI) remains underutilized. Recent trials have provided new data, prompting a need for updated insights. This study aimed to perform a comprehensive meta-analysis to compare the clinical outcomes of intravascular imaging-guided PCI versus angiography-guided PCI, thereby evaluating the relative effectiveness of these two guidance strategies in improving patient outcomes. Methods: PubMed, Cochrane Library, Embase and Clinicaltrials.gov databases were systematically searched from inception till 25 November 2024. Randomized clinical trials (RCTs) comparing intravascular imaging with coronary angiography in patients undergoing complex PCI were included. Statistical analysis was conducted using a random effects model to calculate pooled risk ratios with 95% confidence intervals (CI). Results: In this meta-analysis of 21 studies involving 18,043 patients, intravascular image-guided PCI significantly reduced the risk of all-cause mortality by 24%, cardiac mortality by 63%, MACE by 35%, target vessel myocardial infarction by 32%, stent thrombosis by 42%, target vessel revascularization by 45%, target lesion revascularization by 34% and myocardial infarction by 22% compared to angiography-guided PCI. There was no significant difference in bleeding events. Conclusions: Intravascular imaging significantly reduces cardiac events, all-cause mortality and revascularization rates in PCI patients. These findings support its broader adoption and potential updates to clinical guidelines.
Date Issued
2025-05-06
Date Acceptance
2025-04-25
Citation
Diagnostics, 2025, 15 (9)
ISSN
2075-4418
Publisher
MDPI AG
Journal / Book Title
Diagnostics
Volume
15
Issue
9
Copyright Statement
© 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
License URL
Identifier
10.3390/diagnostics15091175
Subjects
Kumar, A.
Nadeem, M.S.
Kumar, S.
Akhtar, M.
Maryam, A.
Sheikh, R.
Kumar, N.
Ladhwani, N.K.
Madhwani, N.
Kumari, N.
et al. Intravascular Imaging-Guided Versus Angiography-Guided Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis of Randomized Controlled Trials percutaneous coronary intervention
intravascular ultrasonography
intravascular imaging
angiography
meta-analysis
Publication Status
Published
Article Number
ARTN 1175