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July 27, 2023Journal of Clinical MedicineOpen Access

The primary outcome of MACE did not significantly differ between the groups (p = 0.40), although stent thrombosis was significantly reduced with the IVUS-guided approach (p = 0.01).

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Why the study?

The impact of intravascular ultrasound (IVUS) on clinical and procedural outcomes during CTO-PCI remained uncertain.

Does IVUS-guided CTO-PCI reduce major adverse cardiac events compared to angiography-guided CTO-PCI in patients with stable CAD and CTO?

Population

2320 patients with stable CAD and CTO across five studies

Comparison

IVUS-guided vs angiography-guided CTO-PCI

Design

Systematic review and meta-analysis

Authors

GPGiuseppe PanuccioYAYoussef S. AbdelwahedNCNicole Carabetta

Discussion

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Overview

IVUS may reduce stent thrombosis in CTO-PCI; leaves open effects on major clinical outcomes.

Structured PICO

Does IVUS-guided CTO-PCI reduce major adverse cardiac events compared to angiography-guided CTO-PCI in patients with stable CAD and CTO?

P
Population
5 studies pooling 2320 patients with stable coronary artery disease (CAD) and chronic total occlusions (CTO)
I
Intervention
IVUS-guided percutaneous coronary intervention (CTO-PCI)
C
Comparator
Angiography-guided percutaneous coronary intervention (CTO-PCI)
O
Outcome
Major adverse cardiac events (MACE)composite

Routine IVUS guidance during CTO-PCI does not significantly reduce overall MACE but is associated with a reduction in stent thrombosis and changes in procedural metrics.

Cite This Study

Panuccio et al. (2023) studied this question.

synapsesocial.com/papers/6a7e131fcff410f9bee4fc21https://doi.org/10.3390/jcm12154947
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1A comparative study of chronic total occlusion-percutaneous coronary intervention with and without intravascular ultrasound-guided wiring with respect to acute procedural outcome: A single center experience2025
  2. 2IVUS GUIDED VERSUS MULTI-SLICE CT CORONARY ANGIOGRAPHY PLANNED PERCUTANEOUS CORONARY INTERVENTION COMPARED TO THE CONVENTIONAL CORONARY ANGIOGRAPHY GUIDED INTERVENTION.2019
  3. 3Optimizing chronic total occlusion percutaneous coronary intervention: a comparative study of imaging-guided vs. conventional strategies2025
  4. 4Clinical Outcomes Following Optical Coherence Tomographic versus Intravascular Ultrasound-Guided Percutaneous Coronary Intervention: A Meta-Analysis of Randomized Controlled Trials2024
  5. 5Comparative Impact of Coronary Imaging Strategies in CTO-PCI: A Retrospective Single-Center Analysis2025