Intravascular Imaging-Guided Percutaneous Coronary Intervention for Calcified Coronary Lesions: A Network Meta-Analysis
Authors' conclusion
In calcified coronary lesions, intravascular imaging is associated with lower MACE and stent thrombosis, compared with angiography guidance.
Study context
- Population
- Patients with calcified coronary lesions undergoing percutaneous coronary intervention (PCI)
- Participants
- 4,003 patients10 studies
- Comparison
- Intravascular ultrasound (IVUS) or optical coherence tomography (OCT) vs angiography-guided PCI
- Outcome
- Major adverse cardiovascular events (MACE):
- Cardiac death
- Target vessel myocardial infarction
- Target vessel revascularization
Methodological detailsRandomized and observational studies
- Randomized and observational studies
Pooled result
As reported in the abstract
Each group vs angiographyRelative risk (95% CI)
IVUS
0.56(0.37–0.86)
OCT
0.65(0.52–0.82)
Further pooled results
| Outcome | RR (95% CI) | |
|---|---|---|
| Stent thrombosisIVUSvs angiography | 0.15 (0.03–0.89) | |
| Stent thrombosisOCTvs angiography | 0.12 (0.03–0.46) | |
| 0.050.21520Relative risk (log scale) |
| Outcome | MD (mm²) (95% CI) |
|---|---|
| Minimum stent area (MSA)OCT vs angiography · larger with OCT | +0.87 (+0.03 to +1.70) |
Minimum stent area (MSA)
- IVUS showed a nonsignificant trend in the same direction
Target vessel failure, target lesion revascularization, target vessel revascularization (TVR)
- No significant differences, trend in favor of imaging guidance
Heterogeneity
- Heterogeneity was low except for MSA
Original publication
Intravascular Imaging-Guided Percutaneous Coronary Intervention for Calcified Coronary Lesions: A Network Meta-Analysis. JACC Adv. Published 17 September 2026. doi:10.
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