Utility of Intravascular Ultrasound in Peripheral Vascular Interventions: Systematic Review and Meta-Analysis
| Autor: | Fiorella Llanos, Carlos Mena-Hurtado, Sameer Nagpal, Qurat-ul-ain Jelani, Marabel Schneider, Robert R. Attaran, Mahesh Anantha-Narayanan, Kim G. Smolderen, Azfar Bilal Sheikh, Costin N. Ionescu, S. Elissa Altin, C. J. Regan |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Psychological intervention 030204 cardiovascular system & hematology Radiography Interventional Endovascular therapy Amputation Surgical Peripheral Arterial Disease 03 medical and health sciences 0302 clinical medicine Risk Factors Catheterization Peripheral Intravascular ultrasound medicine Humans 030212 general & internal medicine Ultrasonography Interventional Vascular Patency Aged Aged 80 and over medicine.diagnostic_test business.industry Endovascular Procedures Angiography General Medicine Middle Aged Limb Salvage Peripheral Treatment Outcome Meta-analysis Female Surgery Radiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | Vascular and Endovascular Surgery. 54:413-422 |
| ISSN: | 1938-9116 1538-5744 |
| DOI: | 10.1177/1538574420920998 |
| Popis: | Objectives: We sought to compare outcomes between intravascular ultrasound– (IVUS) versus angiography (AO)-guided peripheral vascular interventions (PVIs). Introduction: Intravascular ultrasound facilitates plaque visualization and angioplasty during PVIs for peripheral arterial disease. It is unclear whether IVUS may improve the durability of PVIs and lead to improved clinical outcomes. Methods: This is a study-level meta-analysis of observational studies. The primary end points of this study were rates of primary patency and reintervention. Secondary end points included rates of vascular complications, periprocedural adverse events, amputations, technical success, all-cause mortality, and myocardial infarction. Results: Eight observational studies were included in this analysis with 93 551 patients. Mean follow-up was 24.2 ± 15 months. Intravascular ultrasound–guided PVIs had similar patency rates when compared with AO-guided PVIs (relative risk [RR]: 1.30, 95% confidence interval [CI]: 0.99-1.71, P = .062). There was no difference in rates of reintervention in IVUS-guided PVIs when compared to non-IVUS-guided PVIs (RR: 0.41, 95% CI: 0.15-1.13, P = .085). There is a lower risk of periprocedural adverse events (RR: 0.81, 95% CI: 0.70-0.94, P = .006) and vascular complications (RR: 0.81, 95% CI: 0.68-0.96, P = .013) in the IVUS group. All-cause mortality (RR: 0.76, 95% CI: 0.56-1.04, P = .084), amputation rates (RR 0.83, 95% CI: 0.32-2.15, P = .705), myocardial infarctions (RR: 1.19, 95% CI: 0.58-2.41, P = .637), and technical success (RR: 1.01, 95% CI: 0.86-1.19, P = .886) were similar between the groups. Conclusions: Intravascular ultrasound–guided PVIs had similar primary patency and reintervention when compared with AO-guided PVIs with significantly lower rates of periprocedural adverse events and vascular complications in the IVUS-guided group. |
| Databáze: | OpenAIRE |
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