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The optical coherence tomography (OCT) has high axial and lateral resolution which is superior to that of Intravascular ultrasound (IVUS). There is limited data comparing OCT, IVUS and conventional Coronary angiography (CA).
We searched the PubMed, Embase, CENTRAL and https://clinicaltrials.gov for randomized controlled trials comparing CA, OCT or IVUS for optimization of percutaneous coronary interventions. The network meta-analyses or mixed treatment comparisons for each outcome were conducted using Bayesian hierarchical random-effect models and noninformative priors. Analyses were performed with the R software. Results are reported in form of risk ratios [ES) and their 95% credible intervals.
Eleven trials, comprising 4, 766 patients, met inclusion criteria and were included in this analysis. Mean follow up was 15.3 months. The IVUS was associated with significantly lower risk of cardiovascular mortality, myocardial infarction, stent thrombosis and major adverse cardiovascular events compared to CA [Figure]. The OCT similarly resulted in lower risk of all aforementioned clinical outcomes but results did not cross unity because of paucity of clinical trial data. Overall, OCT or IVUS did not differ in any clinical outcome studied. There was no significant inconstancy or heterogeneity in the network.
The OCT or IVUS guided percutaneous coronary interventions are associated with superior clinical outcomes. There is no significant difference among outcomes of OCT or IVUS optimized Percutaneous Coronary Intervention.
IMAGING: Imaging: Intravascular