CBS 2019
CBSMD教育中心
中 文

IVUS Guidance

Abstract

Recommended Article

Comparison of intravascular ultrasound versus angiography-guided drug-eluting stent implantation: a meta-analysis of one randomised trial and ten observational studies involving 19,619 patients In-stent neoatherosclerosis: a final common pathway of late stent failure Intravascular ultrasound guidance improves clinical outcomes during implantation of both first- and second-generation drug-eluting stents: a meta-analysis Contribution of stent underexpansion to recurrence after sirolimus-eluting stent implantation for in-stent restenosis Defining a new standard for IVUS optimized drug eluting stent implantation: the PRAVIO study Coronary artery imaging with intravascular high-frequency ultrasound Comparison of paclitaxel-eluting stents (Taxus) and everolimus-eluting stents (Xience) in left main coronary artery disease with 3 years follow-up (from the ESTROFA-LM registry) Intravascular ultrasound-derived minimal lumen area criteria for functionally significant left main coronary artery stenosis
|<<... 11 12 13 14 15 16 17 18 >>|

Review Article2013 Dec 5;170(1):54-63.

JOURNAL：Int J Cardiol. Article Link

Use of IVUS guided coronary stenting with drug eluting stent: a systematic review and meta-analysis of randomized controlled clinical trials and high quality observational studies

Klersy C, Ferlini M, Raisaro A et al. Keywords: IVUS guidance; DES implantation; MACE, mortality; MI

ABSTRACT

BACKGROUND/OBJECTIVES - Long term safety of DES, particularly regarding thrombosis is of concern. The hypothesized underlying mechanisms (stent under expansion, malapposition) could be prevented by IVUS guidance. Aim of this meta-analysis of randomized controlled clinical trials (RCT) and high quality observational cohort studies (HQ-OBS) is to quantify the potential clinical benefit of intravascular ultrasound (IVUS) guidance in drug-eluting stents (DES) implantation.


METHODS - We performed an extensive literature search for full-text articles published in 2003–2013. The primary outcome was the rate of major adverse cardiac events (MACE) in RCT and HQ-OBS; secondary outcomes were death, myocardial infarction (MI), revascularization, thrombosis and post-procedural minimum lumen diameter (MLD). Fixed/random effect relative risks (RRs) or standardized mean difference (SMD) and 95% confidence interval (95% CI) were computed for the meta-analysis.


RESULTS - Thirty-four articles were retrieved from 268 found; of these 3 were RCT and 9 were HQ-OBS; 18,707 patients were enrolled, 1037 in RCT and 17,670 in OBS. Median follow-up was 20 months. IVUS guidance was associated with a significantly lower rate of MACE (RR=0.80, 95% CI 0.71–0.89, p b 0.001), death (RR=0.60, 95% CI 0.48–0.74, p b 0.001), MI (RR=0.59, 95% CI 0.44–0.80, p=0.001) and thrombosis (RR=0.50, 95% CI 0.32–0.80, p=0.007) and larger MLD (SMD=0.15, 95% CI 0.03 to 0.27, p=0.014), but not of revascularization (RR=0.95, 95% CI 0.82–1.09, p=0.75).


CONCLUSIONS - In this meta-analysis, IVUS guidance in DES implantation appears to reduce MACE, mortality and MI, possibly by reducing thrombosis rather than restenosis rate. Patients at high risk for thrombosis might be identified as the best candidate for IVUS guidance.
>CBS CBS 2019

> CBS 2019 REGISTRATION

> CBS 2019 PROGRAM

> CBS 2019 CALL FOR SCIENCE

> CBS 2019 SPOTLIGHTS

 CBSMD

> CBSMD WEBSITE REGISTRATION

> EDUCATION CENTER

> RECOMMANDED PAPER

> TOP 10 RESEARCH PAPER

> PRE-READING

CBS 2019 CBS 2019 FACULTY Education Resource CBSMD Scientific Library
Copyright ⓒ CBS MD Nanjing China. All rights reserved. 京ICP备16025898号-11
联系我们| Top