Coronary disease & ACSMeta-analysis
IVUS, Optical Coherence Tomography (OCT), or Angiography as Guidance for Percutaneous Coronary Intervention (PCI) in Complex Coronary Artery Lesions
- Systematic review and network meta-analysis of randomised trials
- lesion-level
- frequentist random-effects model
Authors' conclusion
In patients with complex coronary lesions undergoing PCI with DES, both OCT-guided PCI and IVUS-guided PCI are more effective at reducing MACE compared with angiography-guided PCI.
Study context
- Population
- Patients with complex coronary lesions undergoing PCI with drug-eluting stents
- Participants
- 13,751 patients · 17 RCTs
- Comparison
- IVUS-guided vs OCT-guided vs angiography-guided PCI
- Outcome
- MACE:
- Cardiac death
- MI
- Target vessel revascularization
Pooled result
As reported in the abstract
MACE
Relative risk (95% CI)P value
OCT vs Angiography
0.63(0.55–0.72)
P < 0.001IVUS vs Angiography
0.67(0.56–0.79)
P < 0.001OCT vs IVUSno significant difference
0.94(0.78–1.14)
P = 0.52Further pooled results
Major adverse cardiovascular events (MACE) in subgroups (chronic total occlusions, left main CAD, bifurcation lesions, multivessel CAD, moderately or severely calcified lesions)
- Results consistent in these subgroups
Original publication
IVUS, OCT, or Angiography as Guidance for PCI in Complex Coronary Artery Lesions. JACC Cardiovasc Interv. Published 12 January 2026. doi:10.1016/j.jcin.2025.11.021
Summarised from the published abstract; every number is checked against it