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Meta-analysis of outcomes after intravascular ultrasound-guided versus angiography-guided drug-eluting stent implantation in 26,503 patients enrolled in three randomized trials and 14 observational studies The effect of complete percutaneous revascularisation with and without intravascular ultrasound guidance in the drugeluting stent era Assessment Of Proximal Left Anterior Descending Artery Size By Intravascular Ultrasound For Optimal Stent Sizing Incidence and Clinical Outcomes of Stent Fractures on the Basis of 6,555 Patients and 16,482 Drug-Eluting Stents From 4 Centers Clinical impact of intravascular ultrasound guidance in drug-eluting stent implantation for unprotected left main coronary disease: pooled analysis at the patient-level of 4 registries Meta-analysis of outcomes after intravascular ultrasound-guided versus angiography-guided drug-eluting stent implantation in 26,503 patients enrolled in three randomized trials and 14 observational studies Temporal Trends in Inpatient Use of Intravascular Imaging Among Patients Undergoing Percutaneous Coronary Intervention in the United States Intravascular ultrasound-guided drug-eluting stent implantation: An updated meta-analysis of randomized control trials and observational studies Usefulness of intravascular ultrasound to predict outcomes in short-length lesions treated with drug-eluting stents Impact of the Use of Intravascular Imaging on Patients Who Underwent Orbital Atherectomy
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Editorial2019 Oct 12;394(10206):1299-1300.

JOURNAL：Lancet. Article Link

Expansion or contraction of stenting in coronary artery disease?

Taggart DP, Pagano D. Keywords: PCI vs CABG; left main

ABSTRACT

In the past four decades, more than 20 trials of percutaneous coronary intervention (PCI) versus coronary artery bypass grafting (CABG) have tested whether iterative technical advances in PCI have made it as effective as CABG in patients with stable coronary artery disease. The clinical relevance of most of these trials to real-world practice has, however, been plagued by three issues.


First, by largely enrolling highly selected patients with low-severity coronary artery disease, the trials were inherently biased towards more favourable outcomes for PCI. Second, by limiting follow-up to a few years, the trials hid the accelerating divergence in survival benefit of CABG. Third, even in relatively contemporary trials, surgical patients received substantially inferior medical therapy, thereby mitigating the overall benefits of CABG. 
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