Intravascular ultrasound (IVUS) offers precise information about lesion morphology and enhances the optimization of endovascular treatments (EVT). Nevertheless, the impact of IVUS on the durability of EVTs and clinical outcomes remains uncertain. The aim of this systematic review and meta-analysis was to evaluate the efficacy of IVUS-guided EVT compared with angiography-guided EVT. We conducted a meta-analysis of trials comparing IVUS-guided and angiography-guided EVT. The primary end point was binary restenosis, whereas the secondary end points included reintervention, major amputation, death or amputation, and major adverse limb events (MALE). This meta-analysis included 19 studies with 800,452 patients. Compared with angiography-guided EVT, IVUS-guided EVT significantly reduced the risk of binary restenosis (risk ratio [RR] 0.63, 95% confidence interval [CI] 0.43 to 0.91, p = 0.02). It also reduced the risk of reintervention (RR 0.59, 95% CI 0.39 to 0.90, p = 0.01), major amputation (RR 0.85, 95% CI 0.74 to 0.98, p = 0.02), death or amputation (RR 0.72, 95% CI 0.56 to 0.91, p = 0.007), and MALE (RR 0.52, 95% CI 0.28 to 0.94, p = 0.03). Subgroup analysis for femoropopliteal disease revealed consistent benefits of IVUS guidance regarding binary restenosis (RR 0.63, 95% CI 0.42 to 0.94, p = 0.03), reintervention (RR 0.51, 95% CI 0.33 to 0.80, p = 0.003), major amputation (RR 0.85, 95% CI 0.73 to 0.99, p = 0.04), death or amputation (RR 0.68, 95% CI 0.51 to 0.90, p = 0.007), and MALE (RR 0.51, 95% CI 0.27 to 0.96, p = 0.04). The sensitivity analysis of studies using drug-coated devices also showed the consistent benefit of IVUS guidance regarding binary restenosis. In conclusion, compared with angiography, IVUS-guided EVT provided improved clinical outcomes in terms of binary restenosis, reintervention, major amputation, death or amputation, and MALE in lower extremity artery disease, including femoropopliteal disease.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.amjcard.2024.12.012 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Drug-Coated Balloons versus Drug-Eluting Stents for the Treatment of De Novo Coronary Artery Disease: A Meta-Analysis of Randomized Controlled Trials.
Rev Cardiovasc Med
December 2024
Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, 100069 Beijing, China.
Background: Because of the limitations in new-generation drug-eluting stents (DES), treatments advocating for non-stents with a drug-coated balloon (DCB) is now of great interest. Here, we conducted a meta-analysis to testify whether a DCB was more effective and safer than a DES in treating de novo coronary artery disease (CAD).
Methods: We searched PubMed, Embase, Cochrane Library, and Web of Science to obtain high-quality trials comparing DCB with DES for the treatment of de novo CAD.
Objective: Analysis of risk factors for restenosis after intervention for tuberculous airway stenosis.
Methods: We retrospectively collected the clinical data of patients diagnosed with tuberculous airway stenosis in the Second Hospital of Lanzhou University and Lanzhou Pulmonary Hospital from January 2021 to June 2023. The patients were divided into the restenosis group and the non-restenosis group according to whether or not restenosis occurred in the airway within 1 year after the intervention, and the differences in the clinical data between the two groups were compared, and the variables with statistically significant differences in the univariate analysis were analyzed by multifactorial binary logistic regression.
Meta-Analysis of Intravascular Ultrasound-Guided Versus Angiography-Guided Endovascular Treatment in Lower Extremity Artery Disease.
Am J Cardiol
December 2024
Department of Thoracic and Cardiovascular Surgery, Busan Paik Hospital, Inje University College of Medicine, Busan, South Korea.
Intravascular ultrasound (IVUS) offers precise information about lesion morphology and enhances the optimization of endovascular treatments (EVT). Nevertheless, the impact of IVUS on the durability of EVTs and clinical outcomes remains uncertain. The aim of this systematic review and meta-analysis was to evaluate the efficacy of IVUS-guided EVT compared with angiography-guided EVT.
View Article and Find Full Text PDFResults of SurVeil Versus IN.PACT Admiral Paclitaxel Coated Balloons in Femoropopliteal Arteries: Outcomes of the Randomised TRANSCEND Study Through 24 Months.
Eur J Vasc Endovasc Surg
November 2024
Vascular Medicine and Intervention, Massachusetts General Hospital, Boston, MA, USA.
Article Synopsis
- * In this randomized controlled trial involving 446 patients, the SurVeil PCB showed a primary safety rate of 91.8% and a primary efficacy rate of 82.2%, while the IN.PACT Admiral had rates of 89.8% and 85.9%, respectively.
- * The results indicate that the SurVeil PCB is a safe and effective treatment option, demonstrating non-inferiority to the IN.PACT Admiral PCB over a 24-month period.
Drug-coated balloons versus drug-eluting stents in patients with in-stent restenosis: An updated meta-analysis with trial sequential analysis.
J Cardiothorac Surg
November 2024
Medical Research group of Egypt (MRGE), Cairo, Egypt.
Background: Drug-coated balloons (DCB) have promising results in the management of in-stent restenosis (ISR), still their role remains a major challenge, and not well established in contemporary clinical practice.
Aims: To provide a comprehensive appraisal of the efficacy and safety of DCBs in patients with in-stent restenosis (ISR).
Methods: We searched PubMed, Scopus, web of Science, Ovid, and Cochrane Central from inception until 30 March, 2023.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!