Intravascular Imaging-Guided Drug-Eluting Stenting for Complex Coronary Lesions
- meta-analysis of randomized controlled trials (RCTs)
- frequentist random-effects models
- complementary Bayesian analyses
- sensitivity and subgroup analyses
+3 more
- frequentist random-effects models
- complementary Bayesian analyses
- sensitivity and subgroup analyses
Authors' conclusion
IVI guidance reduces the risk of adverse events for complex lesions. The benefit was in part driven by achieving imaging-defined stent optimization.
Study context
- Population
- Patients with complex coronary lesions
- Participants
- 18,975 patients · 18 RCTs
- Comparison
- Intravascular imaging (IVI)-guided vs angiography-guided percutaneous coronary intervention (PCI)
- Outcome
- Major adverse cardiovascular events (MACE) and cardiac death
Pooled result
As reported in the abstract
Major adverse cardiovascular events (MACE) and cardiac death
IVI-guided PCI vs angiography-guided PCIRelative risk (95% CI)
MACE
0.67(0.55–0.83)
Cardiac death
0.72(0.53–0.97)
Further pooled results
| Outcome | RR (95% CI) | |
|---|---|---|
| Myocardial infarction | 0.87 (0.76–0.998) | |
| Clinically driven target lesion revascularization | 0.72 (0.51–0.999) | |
| Stent thrombosis | 0.52 (0.35–0.78) | |
| Events by imaging-defined stent optimization (subgroup) · lower event rates with optimization | 0.41 (0.26–0.62) | |
| 0.20.5125Relative risk (log scale) |
Major adverse cardiovascular events (MACE) by geography (subgroup)
- Significant geographic interaction, benefit predominantly driven by Asian trial populations
- P for interaction < 0.01
Original publication
Intravascular Imaging-Guided Drug-Eluting Stenting for Complex Coronary Lesions. JACC Adv. Published 15 October 2026. doi:10.
Summarised from the published abstract; every number is checked against it