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Comprehensive intravascular ultrasound assessment of stent area and its impact on restenosis and adverse cardiac events in 403 patients with unprotected left main disease Role of intravascular ultrasound in patients with acute myocardial infarction undergoing percutaneous coronary intervention Coronary plaque redistribution after stent implantation is determined by lipid composition: A NIRS-IVUS analysis Usefulness of intravascular ultrasound guidance in percutaneous coronary intervention with second-generation drug-eluting stents for chronic total occlusions (from the Multicenter Korean-Chronic Total Occlusion Registry) Novel predictors of late lumen enlargement in distal reference segments after successful recanalization of coronary chronic total occlusion The impact of intravascular ultrasound guidance during drug eluting stent implantation on angiographic outcomes Long-term survival in patients undergoing percutaneous interventions with or without intracoronary pressure wire guidance or intracoronary ultrasonographic imaging: a large cohort study Impact of Positive and Negative Lesion Site Remodeling on Clinical Outcomes : Insights From PROSPECT Intravascular Ultrasound Assessment of In-Stent Restenosis in Saphenous Vein Grafts 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
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Review Article2014 Apr 15;113(8):1338-47

JOURNAL：Am J Cardiol. Article Link

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

Ahn JM, Kang SJ, Park SJ et al. Keywords: IVUS guided PCI; angiography-guided PCI; DES; outcome

ABSTRACT

There are conflicting data regarding the benefit of intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) over angiography-guided PCI. Since the last meta-analysis was published, several new studies have been reported. We performed a comprehensive meta-analysis to evaluate the clinical impact of IVUS-guided PCI with drug-elutingstent compared with conventional angiography-guided PCI. This meta-analysis included 26,503 patients from 3 randomized and 14observationalstudies; 12,499 patients underwent IVUS-guided PCI and 14,004 underwent angiography-guided PCI. Main outcome measures were total mortality, myocardial infarction (MI), stent thrombosis, and target lesion revascularization (TLR). IVUS-guided PCI was significantly associated with more stents, longer stents, and larger stents. Regarding clinical outcomes, IVUS-guided PCI was associated with a significantly lower risk of TLR (odds ratio [OR] 0.81, 95% confidence interval [CI] 0.66 to 1.00, p=0.046). In addition, the risk of death (OR 0.61, 95% CI 0.48 to 0.79, p<0.001), MI (OR 0.57, 95% CI 0.44 to 0.75, p<0.001), and stent thrombosis (OR 0.59, 95% CI 0.47 to 0.75, p<0.001) were also decreased. In conclusion, our meta-analysis demonstrated that IVUS-guided PCI was associated with lower risk of death, MI, TLR, and stent thrombosis after drug-eluting stenti mplantation.

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