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Updated: Jun 26, 2025
Retrograde Perfusion and Filling of Mouse Coronary Vasculature as Preparation for Micro Computed Tomography Imaging
Published on: February 10, 2012
Comparison between Imaging and Physiology in Guiding Coronary Revascularization: A Meta-Analysis
Riccardo Improta1, Gianluca Di Pietro1, Michele Giansanti1
1Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Umberto I Hospital, Sapienza University of Rome, Viale del Policlinico 155 (Emodinamica A, Ottavo Padiglione, II Piano), 00161 Rome, Italy.
Imaging-guided percutaneous coronary intervention (PCI) may reduce the need for repeat procedures compared to physiology-guided PCI. This finding holds true regardless of acute coronary syndromes (ACS) presentation.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Imaging
Background:
- Percutaneous coronary intervention (PCI) is a key revascularization method for coronary artery disease.
- The optimal guidance strategy for PCI, between imaging and physiology, remains debated.
- Intermediate coronary lesions (ICLs) present a particular challenge in PCI decision-making.
Purpose of the Study:
- To systematically compare clinical outcomes of imaging-guided versus physiology-guided PCI.
- To evaluate the effectiveness of these guidance strategies in managing intermediate coronary lesions (ICLs).
- To assess the influence of acute coronary syndromes (ACS) presentation on PCI outcomes.
Main Methods:
- A meta-analysis of seven eligible studies involving 5701 patients, adhering to PRISMA guidelines.
- Literature search conducted across major databases up to December 2023.
- Outcome measures included major adverse cardiovascular events (MACE), target vessel revascularization (TVR), target vessel failure (TVF), and target lesion revascularization (TLR).
Main Results:
- Imaging-guided PCI was associated with significantly lower rates of target vessel revascularization (TVR) (OR 0.70, p=0.02) compared to physiology-guided PCI.
- No significant differences were observed in major adverse cardiovascular events (MACE), target vessel failure (TVF), or target lesion revascularization (TLR) between the two strategies.
- Subgroup analysis for intermediate coronary lesions (ICLs) and meta-regression for acute coronary syndromes (ACS) presentation showed no significant differences.
Conclusions:
- Imaging-guided PCI may offer an advantage by reducing the need for subsequent target vessel revascularization.
- The choice of guidance strategy did not significantly impact major adverse cardiovascular events or outcomes in patients with acute coronary syndromes.
- These findings support informed clinical decisions regarding PCI guidance strategies.
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