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Updated: Jun 17, 2026

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

Intravascular imaging-guided versus angiography-guided percutaneous coronary intervention in multivessel coronary

Ahmed Adel Mohamed1, Asmaa Magdy Elhefnawy1, Abdalrahman Salah Shehata2

  • 1Faculty of Medicine, Zagazig University, Zagazig, Egypt.

BMC Cardiovascular Disorders
|June 16, 2026
PubMed

Insights

Intravascular imaging significantly reduces major adverse cardiovascular events in multivessel coronary artery disease patients undergoing percutaneous coronary intervention. Both intravascular ultrasound and optical coherence tomography offer similar benefits over traditional angiography.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Medical Imaging

Background:

  • Percutaneous coronary intervention (PCI) for multivessel coronary artery disease presents challenges due to anatomical complexity and risks of adverse cardiovascular outcomes.
  • Conventional angiography offers limited insights into vessel structure and plaque characteristics.
  • Intravascular imaging modalities like intravascular ultrasound (IVUS) and optical coherence tomography (OCT) may enhance PCI procedural guidance, but their clinical impact is uncertain.

Purpose of the Study:

  • To systematically evaluate the clinical impact of intravascular imaging-guided PCI versus angiography-guided PCI in patients with multivessel coronary artery disease.
  • To compare the effectiveness of IVUS and OCT in reducing major adverse cardiovascular events (MACE).

Main Methods:

  • A systematic review and meta-analysis of randomized controlled trials (RCTs) comparing imaging-guided versus angiography-guided PCI.
  • Search of major databases through December 2025 for relevant RCTs.
  • Pooled analysis of outcomes using random-effects models, risk ratios (RRs), and 95% confidence intervals (CIs).
  • Inclusion of Trial Sequential Analysis (TSA) and exploratory Network Meta-Analysis (NMA).

Main Results:

  • Analysis of 5 RCTs involving 3,023 patients revealed a significant reduction in MACE with imaging-guided PCI compared to angiography-guided PCI (RR 0.58, 95% CI 0.46-0.74).
  • Subgroup analyses showed significant MACE reduction with both IVUS-guided PCI (RR 0.53, 95% CI 0.39-0.73) and OCT-guided PCI (RR 0.49, 95% CI 0.28-0.87).
  • TSA supported the beneficial effect of imaging guidance, and NMA indicated comparable outcomes between IVUS and OCT, both superior to angiography.

Conclusions:

  • Intravascular imaging-guided PCI demonstrably reduces MACE in patients with multivessel coronary artery disease.
  • The findings underscore the clinical utility of intravascular imaging (IVUS and OCT) in this patient cohort.
  • Both IVUS and OCT provide similar benefits, supporting their integration into routine practice for complex PCI procedures.
Abstract

Keywords:
Coronary artery diseaseIntravascular imagingIntravascular ultrasoundMajor adverse cardiovascular eventsMultivessel coronary artery diseaseOptical coherence tomographyPercutaneous coronary intervention

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