| Buccheri S, et al.[5]
|
2017 |
n = 17,882 |
PCI guidance using either IVUS or OCT was associated with a significant reduction of major adverse cardiovascular events (OR = 0.79; 95% CI: 0.67–0.91 and OR: 0.68; 95% CI: 0.49–0.97, respectively) and cardiovascular death (OR = 0.47; 95% CI: 0.32–0.66 and OR = 0.31; 95% CI: 0.13–0.66, respectively). |
| Smilowitz NR, et al.[6]
|
2018 |
n = 3,211,872 |
Among 3,211,872 hospitalizations with coronary angiography, intracoronary imaging was performed in 88,775 cases (4.8% of PCI and 1.0% of diagnostic procedures), with IVUS in 98.9% and OCT in 1.1% of cases. Among patients undergoing PCI, the rate of intravascular coronary imaging increased from 2.1% in 2004–2005 to 6.6% in 2013–2014 (P < 0.001 for trend). Use of intravascular coronary imaging was associated with lower in-hospital mortality in patients undergoing PCI (adjusted OR = 0.77; 95% CI: 0.71–0.83). |
| Hibi K, et al.[10]
|
2000 |
n = 35 |
IVUS studies using a 40-MHz transducer were performed in 35 patients with coronary artery disease. A total of 620 gray-scale images (310 pairs) were processed with and without the BNR, and lumen cross-sectional area (CSA) was determined by 2 independent observers. With the BNR, the intra-observer and interobserver correlation coefficients for lumen CSA were significantly improved (0.85 to 0.99 and 0.80 to 0.98, respectively). |
| Takarada S, et al.[16]
|
2010 |
n = 14 |
The mean time of the OCT procedure in this study from setup to completion of image acquisition was 3.2 ± 0.8 min for FD-OCT and 11.2 ± 2.5 min for TD-OCT (P < 0.01). In qualitative image assessment, FD-OCT has the potential to yield a higher rate of clear image segments (CIS) than TD-OCT (99.4% vs. 80.8%, respectively; P < 0.01). In addition to these improved characteristics, there were no ischemic ECG changes or arrhythmia associated with FD-OCT. |
| Jang Ik, et al.[17]
|
2002 |
n = 42 |
A total of 17 IVUS and OCT image pairs obtained from patients were compared. Axial resolution measured 13 ± 3 microm with OCT and 98 ± 19 microm with IVUS. All fibrous plaques, macrocalcifications and echolucent regions identified by IVUS were visualized in corresponding OCT images. Intimal hyperplasia and echolucent regions, which may correspond to lipid pools, were identified more frequently by OCT than by IVUS. |
| Imola F, et al.[19]
|
2010 |
n = 74 |
OCT findings led to additional interventions in 24 out of 74 patients (32%): 15 had further balloon inflations, nine had additional stent deployment whilst two had both treatments. At clinical follow-up, (4.6 ± 3.2 months), there were no death, acute myocardial infarctions, and cases of stent thrombosis, whilst two patients underwent revascularization for recurrence of angina. |
| Parise H, et al.[21]
|
2011 |
n = 2,193 |
IVUS guidance was associated with a significantly larger post procedure angiographic minimum lumen diameter. The mean difference was 0.12 mm (95% CI: 0.06–0.18, P < 0.0001). IVUS guidance was also associated with a significantly lower rate of 6-month angiographic restenosis (22% vs. 29%, odds ratio 0.64, 95% CI: 0.42–0.96, P = 0.02), a significant reduction in the revascularization rate (13% vs. 18%, odds ratio 0.66, 95% CI: 0.48–0.91, P = 0.004), and overall major adverse cardiac events (19% vs. 23%, odds ratio 0.69, 95% CI: 0.49–0.97, p = 0.03). |
| Wang Y, et al.[22]
|
2018 |
n = 4,592 |
IVUS guidance was associated with a significant reduction in major adverse cardiac events (RR = 0.61; 95% CI: 0.53–0.70; P < 0.001), all-cause death (RR = 0.55; 95% CI: 0.42–0.71; P < 0.001), cardiac death (RR 0.45; 95% CI: 0.32–0.62; P < 0.001), myocardial infarction (RR 0.66; 95% CI: 0.55-0.80; P < 0.001), and stent thrombosis (RR 0.48; 95% CI: 0.27-0.84; P = 0.01) compared with angiographic guidance |
| Meneveau N, et al.[25]
|
2016 |
n = 240 |
OCT use led to a change in procedural strategy in 50% of the patients in the OCT-guided group. The primary end point was improved in the OCT-guided group, with a significantly higher fractional flow reserve value (0.94 ± 0.04 versus 0.92 ± 0.05, P = 0.005) compared with the angiography-guided group. The rates of procedural complications (5.8%) and acute kidney injury (1.6%) were identical in each group despite longer procedure time and use of more contrast medium in the OCT-guided group. |
| Ali ZA, et al.[26]
|
2023 |
n = 2,487 |
The minimum stent area after PCI was 5.72 ± 2.04 mm2 in the OCT group and 5.36 ± 1.87 mm2 in the angiography group (mean difference, 0.36 mm2; 95% CI: 0.21-0.51; P < 0.001). Target-vessel failure within 2 years occurred in 88 patients in the OCT group and in 99 patients in the angiography group (Kaplan-Meier estimates, 7.4% and 8.2%, respectively; HR = 0.90; 95% CI: 0.67–1.19; P = 0.45). OCT-related adverse events occurred in one patient in the OCT group and in two patients in the angiography group. |
| Ali ZA, et al.[27]
|
2022 |
n = 391 |
The presence of OCT-assessed suboptimal criteria for stent implantation was related to a worse clinical outcome at very long-term follow-up. OCT-assessed suboptimal stent deployment was an independent predictor of long-term DOCE (HR = 2.17, P < 0.001), together with bare metal stent implantation (HR = 1.73, P = 0.003) and prior revascularization (HR = 1.53, P = 0.017). |
| Ali ZA, et al.[28]
|
2016 |
n = 450 |
OCT guidance was non-inferior to IVUS guidance (one-sided 97.5% lower CI -0.70 mm2; P = 0.001), but not superior (P = 0.42). OCT guidance was also not superior to angiography guidance (P = 0.12). Procedural MACE in four (3%) of 158 patients in the OCT group, one (1%) of 146 in the IVUS group, and one (1%) of 146 in the angiography group (OCT vs. IVUS, P = 0·37; OCT vs. angiography P = 0.37). |
| Prati F, et al.[29]
|
2015 |
n = 832 |
Appropriate OCT assessment was obtained in 98.2% of cases and revealed suboptimal stent implantation in 31.0% of lesions, with increased incidence in patients experiencing major adverse cardiac events (MACE) during follow-up (59.2% vs. 26.9%; P < 0.001). |
| Kubo T, et al.[30]
|
2013 |
n = 100 |
In the clinical study, the mean minimum lumen diameter measured by coronary angiography was significantly smaller than that measured by FD-OCT (1.81 ± 0.72 vs. 1.91 ± 0.69 mm; P < 0.001) and the minimum lumen diameter measured by IVUS was significantly greater than that measured by FD-OCT (2.09 ± 0.60 vs. 1.91 ± 0.69 mm; P < 0.001). The minimum lumen area measured by IVUS was significantly greater than that by FD-OCT (3.68 ± 2.06 vs. 3.27 ± 2.22 mm2; P < 0.001), although a significant correlation was observed between the 2 imaging techniques (r = 0.95, P < 0.001; mean difference 0.41 mm2). |
| Lee Sy, et al.[31]
|
2018 |
n = 894 |
OCT-guided DES implantation was compared with angiography-guided DES implantation. Three-month follow-up OCT data were acquired for 779 patients (87.1%). The median percentage of uncovered struts at 3 months was 8.9% and 8.2% in the EES and BES groups, respectively (P = 0.69) and was lower in the OCT-guided group (7.5%) than in the angiography-guided group (9.9%; P = 0.009). Favorable early strut coverage (≤ 6% uncovered strut) was observed in 320 of 779 patients (41.1%). At 12 months, the composite event rarely occurred in the 3-month (0.3%) or 12-month (0.2%) DAPT groups (P = 0.80). |
| Gerbaud E, et al.[33]
|
2015 |
n = 100 |
This study investigates the reproducibility of intravascular optical coherence tomography (IVOCT) assessments compared to intravascular ultrasound (IVUS). The magnitude of inter-institute measurement differences for IVOCT was statistically significantly less than that for IVUS concerning lumen cross-sectional area (CSA), maximum and minimum lumen diameters, stent CSA, and maximum and minimum stent diameters (P < 0.001, P < 0.001, P < 0.001, P = 0.02, P < 0.001, and P = 0.01, respectively). |
| Maehara A, et al.[37]
|
2015 |
n = 940 |
In the matched-pair analysis, the degree of stent expansion was not significantly different between OCT and IVUS guidance (median [first, third quartiles] = 72.8% [63.3, 81.3] vs. 70.6% [62.3, 78.8], respectively, P = 0.29). Similarly, after adjustment for baseline differences in the entire population, the degree of stent expansion was also not different between the 2 imaging modalities (P = 0.84). Although a higher prevalence of post-PCI stent malapposition, tissue protrusion, and edge dissections was detected by OCT, the rates of major malapposition, tissue protrusion, and dissections were similar after OCT- and IVUS-guided stenting. |
| Kubo T, et al.[38]
|
2017 |
n = 829 |
This study compared OFDI-guided PCI to IVUS-guided PCI. OFDI-guided PCI (n = 414) and IVUS-guided PCI (n = 415). Target vessel failure occurred in 21 (5.2%) of 401 patients undergoing OFDI-guided PCI, and 19 (4.9%) of 390 patients undergoing IVUS-guided PCI, demonstrating non-inferiority of OFDI-guided PCI to IVUS-guided PCI (HR = 1.07, upper limit of one-sided 95% CI: 1.80; Pnon-inferiority = 0.042). With 89.8% angiographic follow-up, the rate of binary restenosis was comparable between OFDI-guided PCI and IVUS-guided PCI (in-stent: 1.6% vs. 1.6%, P = 1.00; and in-segment: 6.2% vs. 6.0%, P = 1.00). |
| Batkoff BW, et al.[40]
|
1996 |
n = 718 |
Out of 718 studies 8 complications (spasm, vessel dissection, or guide wire entrapment) were noted. No permanent adverse clinical consequences due to ICUS imaging were reported. There was no difference in frequency of complications between centers, as assessed by chi-square analysis (P = 0.232). These data suggest that ICUS examinations can be performed safely with a very low rate of complications. |
| Van der Sijde JN, et al.[42]
|
2017 |
n = 3,618 |
3,618 procedures were studied. Of these, 1142 procedures used OCT and 2476 procedures used IVUS. Invasive imaging-related complications were rare, did not differ between the two imaging methods (OCT: n = 7, 0.6%; IVUS: n = 12, 0.5%; P = 0.6), and were self-limiting after retrieval of the imaging catheter or easily treatable in the catheterization laboratory. No major adverse events, prolongation of hospital stay, or permanent patient harm was observed. |
| Jones DA, et al.[43]
|
2022 |
n = 87,166 |
OCT-guided PCI had greater procedural success and lower in-hospital MACE versus angiography guidance. Mortality was significantly lower with OCT (7.7%) versus IVUS (12.2%) or angiography (15.7%) guided PCI (P < 0.0001). Both OCT and IVUS predicted better survival than angiography alone, demonstrating superior clinical outcomes when using these advanced imaging techniques for PCI diagnostics. |
| Yoon HJ, et al.[44]
|
2012 |
n = 8,371 |
This study reported long-term outcomes of both IVUS- and angiography-guided PCI using BMS or DES implantation. In the overall population, the 3-year adjusted incidence of mortality was significantly lower in the IVUS-guided PCI group compared with the angiography-guided PCI group (HR = 0.70; 95% CI: 0.56-0.87; P = 0.001). In 2,715 matched pairs of the overall population, the IVUS-guided PCI group also had a lower mortality risk (HR = 0.71; 95% CI: 0.56-0.90; P = 0.005). |
| Tan YY, et al.[45]
|
2019 |
n = 6,282 |
This study demonstrated that the IVUS‐guided PCI group had a lower composite of non‐fatal MI, death, or TLR (13.1% vs. 29.3%, P = 0.031) compared to angiography guided PCI. In terms of MI and all‐cause death at 3 years between IVUS vs. angiography guidance. IVUS guidance provided a significantly lower incidence of the composite of MI and all‐cause death (HR = 0.82, 95% CI: 0.49–1.37; P = 0.001). |
| Maehara A, et al.[46]
|
2018 |
n = 8,852 |
In 3361 IVUS-guided vs. 5221 angiography-guided procedures, IVUS was associated with reduced 2-year rates of: (1) MACE (4.9% vs. 7.5%; HR = 0.72, 95% CI: 0.59-0.89; P = 0.003), (2) definite/probable stent thrombosis (0.55% vs. 1.16%; HR = 0.40, 95% CI: 0.22-0.73; P =0.003), (3) MI (3.5% vs. 5.6%; HR = 0.65, 95% CI: 0.51-0.83; P = 0.0006). Landmark analysis also showed reduced MACE, MI, stent thrombosis, TLR with IVUS at 1–2 years. Number needed to treat with IVUS to prevent 1 MACE fell from 64 at 1 year to 41 at 2 years. |
| Jasti V, et al.[47]
|
2004 |
n = 55 |
In patients with ambiguous LMCS, FFR averaged 0.86 ± 0.13. IVUS parameters were MLD 3.8 ± 0.61 mm, MLA 7.65 ± 2.9 mm2, CSN 59 ± 13%, AS 47 ± 19%. FFR correlated with MLD (r = 0.79) and MLA (r = 0.74). FFR inversely correlated with CSN (r = 0.69) and AS (r = 0.54). MLD 2.8mm had highest sensitivity/specificity (93%/98%) for LMCS significance, followed by MLA 5.9mm2 (93%/95%). 38-month survival and event-free survival were 100% for FFR < 0.75 and 90% for FFR ≥ 0.75 (P = NS). |
| de la Torre Hernandez JM, et al.[48]
|
2011 |
n = 354 |
LMCA revascularization was performed in 90.5% with MLA < 6mm2 and deferred in 96% with MLA ≥ 6 mm2 despite angiographic variability. At 2 years, cardiac death-free survival was 97.7% deferred vs. 94.5% revascularized (P = 0.5); event-free survival 87.3% vs. 80.6% (P = 0.3). Only 8 (4.4%) deferred required subsequent LMCA revascularization, none with infarction. MLA ≥ 6 mm2 appears safe to defer LMCA revascularization given clinical/angiographic inclusion criteria. |
| Abizaid AS, et al.[49]
|
1999 |
n = 122 |
In selected patients assessed by IVUS, moderate LMCA disease had a one-year event rate of only 14%. Intravascular ultrasound MLD was the most important quantitative predictor of cardiac events. For any given MLD, the event rate was exaggerated in the presence of diabetes or another untreated lesion (> 50% DS). |
| Dato I, et al.[50]
|
2017 |
n = 131 |
Based on FD-OCT features, 58 (48%) patients were managed conservatively, 64 (52%) were revascularized (stenting n=48, surgery n=16). After 18 month follow-up, TVF-free survival was similar between conservative management vs. revascularization (HR = 0.40, 95% CI: 0.10-1.61, P = 0.20). Only 2 patients in conservative group had TVF (elective LM stenting, no death/MI). This suggests FD-OCT may identify deferred revascularization options for angiographically intermediate LM bifurcation stenosis. |
| Abizaid AS, et al.[51]
|
1998 |
n = 86 |
There was a linear relation between CFR and IVUS minimum lumen cross-sectional area (CSA) (r = 0.771 overall; r = 0.831 pre-intervention; r = 0.514, post-PTCA; r = 0.623 post-stent). IVUS CSA ≥ 4 mm2 had 89% diagnostic accuracy for CFR ≥ 2.0 (92% pre-intervention). Multivariate determinants of CFR were IVUS minimum CSA (P < 0.0001), lesion length (P = 0.0101), and diabetes (P = 0.0371) (r2 = 0.6224 overall). Pre-intervention, determinants were CSA (P < 0.0001) and lesion length (P = 0.0095) (r2 = 0.7176). |
| Abizaid AS, et al.[52]
|
1999 |
n = 300 |
In 248 lesions, standard clinical, angiographic, and IVUS parameters were collected. Patients followed > 1 year. 24 events occurred including 2 deaths, 4 MIs, 18 TLRs. Diabetes, IVUS lumen area, diameters, plaque burden, and area stenosis were univariate predictors. Only IVUS minimum lumen area and area stenosis were independent predictors of events. Diabetes, IVUS minimum lumen area, and area stenosis predicted TLR. In lesions with minimum lumen area ≥4mm2, event rate was 4.4% and TLR 2.8%. |
| Bech GJ, et al.[53]
|
2001 |
n = 325 |
Event-free survival was similar between deferral and performance groups (92% vs. 89% at 12 months; 89% vs. 83% at 24 months) but lower in reference group (80% at 12 months; 78% at 24 months). Freedom from angina was also similar between deferral and performance (49% vs. 50% at 12 months; 70% vs. 51% at 24 months) but higher in reference group (67% at 12 months; 80% at 24 months). |
| Tonino PA, et al.[54]
|
2009 |
n = 1005 |
The mean number of indicated lesions per patient was similar in the angiography FFR group (P = 0.34). The number of stents used per patient was 2.7 ± 1.2 and 1.9 ± 1.3, respectively. The 1-year event rate was 18.3% (91 patients) in the angiography group and 13.2% (67 patients) in the FFR group (P = 0.02). 78% of patients in the angiography group were free from angina at 1 year, as compared with 81% of patients in the FFR group (P = 0.20). |
| Zimmerman FM, et al.[55]
|
2015 |
n = 325 |
In 325 patients undergoing PCI for intermediate stenosis, FFR was measured pre-PCI. If FFR ≥ 0.75, patients were randomized to deferral (Defer, n = 91) or performance (Perform, n = 90) of PCI. If FFR < 0.75, PCI performed as planned (Reference, n = 144). After 15 years, mortality was similar between groups (Defer 33.0%, Perform 31.1%, Reference 36.1%; P = NS). Myocardial infarction was lower in Defer (2.2%) versus Perform (10.0%) (RR = 0.22, P = 0.03). |
| Johnson NP, et al.[56]
|
2014 |
n = 6,061 |
Clinical events increased as FFR decreased, with larger revascularization benefit at lower FFR. Outcomes-derived FFR thresholds were around 0.75-0.80, limited by confounding. Post-stenting FFR also showed inverse prognosis relationship (HR = 0.86, 95% CI: 0.80-0.93; P < 0.001). FFR-assisted strategy led to about 50% less revascularization versus anatomy-based, with 20% fewer adverse events and 10% better angina relief. |
| Nam CW, et al.[57]
|
2010 |
n = 167 |
Baseline stenosis and lesion length were similar between FFR and IVUS groups (51 ± 8% and 24 ± 12 mm vs. 52 ± 8% and 24 ± 13 mm). However, IVUS-guided group had more revascularization (91.5% vs. 33.7%, P < 0.001). No difference in MACE between groups (3.6% FFR vs. 3.2% IVUS). Predictors for intervention were: IVUS vs. FFR (RR 0.02), LAD vs. non-LAD disease (RR = 5.60), and multi- vs single-vessel disease (RR = 3.28). |
| Briguori C, et al.[58]
|
2001 |
n = 43 |
The combined evaluation of both percent area stenosis and MLD made the IVUS examination more specific (sensitivity 100%, specificity 76%). In 53 intermediate coronary lesions found by angiography, IVUS area stenosis > 70%, MLD < or =1.8 mm, MLA < or = 4.0 mm2, and lesion length > 10 mm reliably identified functionally critical intermediate coronary stenoses. |
| Bezerra HG, et al.[59]
|
2013 |
n = 227 |
FD-OCT showed more severe native coronary disease than IVUS, with smaller minimal lumen area (2.33 vs. 3.32 mm2, P < 0.001). Reference dimensions were equivalent between FD-OCT and IVUS, but FD-OCT detected smaller reference lumen. Post-PCI, in-stent MLAs were similar, but at follow-up FD-OCT and TD-OCT found smaller MLAs than IVUS. FD-OCT more frequently identified post-PCI malapposition and tissue prolapse. |
| Ramasamy A, et al.[60]
|
2020 |
n = 6,919 |
In a pooled analysis, both IVUS- and OCT-derived minimum lumen area (MLA) exhibited similar sensitivity in predicting significant lesions (IVUS-MLA: 0.747 vs. OCT-MLA: 0.732, P = 0.519). However, OCT-MLA demonstrated higher specificity (0.763 vs. 0.665, P < 0.001) and overall diagnostic accuracy for identifying flow-limiting stenosis compared to IVUS-MLA (AUC 0.810 vs. 0.754, P = 0.045). Sub-analysis with a clinically significant FFR cutoff of 0.80 yielded consistent results, indicating that OCT-MLA outperforms IVUS-MLA in accurately detecting hemodynamically significant stenosis (AUC 0.809 vs. 0.750, P = 0.034). |
| Puri R, et al.[61]
|
2020 |
n = 12,092 |
IVUS was used in the ACCELERATE trial and found no significant benefit or harm of evacetrapib on 30-month major adverse cardiovascular events (CV death, myocardial infarction [MI], stroke, coronary revascularization, or hospitalization for unstable angina). This secondary analysis evaluated rates of CV death, MI, and stroke across levels of Lp(a). |
| von Birgelen C, et al.[62]
|
2003 |
n = 60 |
Cholesterol levels influenced IVUS-measured arterial changes:. LDL cholesterol was positively related (r = 0.41, P < 0.0001) to annual plaque plus media cross-sectional area (P&M CSA) changes. An LDL level of 75 mg/dL marked a threshold; below this, no average annual P&M CSA increase was predicted. HDL cholesterol was inversely related (r = –0.30, P < 0.02) to annual P&M CSA changes. LDL cholesterol was inversely linked (r = –0.32, P < 0.01) to annual lumen CSA changes. No significant relationships were found between LDL and HDL cholesterol and annual total arterial CSA changes (remodeling). Patients with LDL cholesterol ≥ 120 mg/dL had more pronounced annual P&M CSA progression and lumen reduction despite similar baseline IVUS characteristics. |
| Nissen SE.[63]
|
2005 |
n = 654 |
The REVERSAL study compared two statins over 18 months using IVUS to measure atherosclerosis. Pravastatin 40 mg reduced LDL cholesterol from 3.9 to 2.8 mmol/L, while atorvastatin 80 mg lowered it to 2.0 mmol/L (P < 0.0001). CRP decreased by 5.2% with pravastatin and 36.4% with atorvastatin (P < 0.0001). Atorvastatin 80 mg significantly slowed atheroma progression across all IVUS measures, while the moderate treatment group experienced progression in all IVUS endpoints. |
| Okazaki S, et al.[64]
|
2004 |
n = 70 |
Volumetric IVUS analyses were conducted at baseline and 6-month follow-up for a non-PCI site in 48 patients (atorvastatin, n=24; control, n = 24). Atorvastatin significantly reduced LDL-C levels by 41.7%, while the control group experienced a 0.7% increase (P < 0.0001). The atorvastatin group also showed a significant reduction in plaque volume (13.1± 12.8% decrease) compared to the control group (8.7 ± 14.9% increase; P < 0.0001). There was a notable positive correlation between the percent change in plaque volume and follow-up LDL-C levels (R = 0.456, P = 0.0011) as well as the percentage reduction in LDL-C (R = 0.612, P < 0.0001), even among patients with baseline LDL-C levels < 125 mg/dL. |
| Nissen SE, et al.[65]
|
2006 |
n = 507 |
The mean (SD) change in percent atheroma volume (PAV) for the entire vessel was -0.98% (3.15%), with a median of -0.79% (97.5% CI: -1.21% to -0.53%) (P < 0.001 vs. baseline). The mean change in atheroma volume in the most diseased 10-mm subsegment was -6.1 ± 10.1 mm3, with a median of -5.6 mm3 (97.5% CI: -6.8 to -4.0 mm3) (P < 0.001 vs. baseline). Change in total atheroma volume showed a 6.8% median reduction; with a mean reduction of -14.7 ± 25.7 mm3, with a median of -12.5 mm3 (95% CI: -15.1 to -10.5 mm3) (P < 0.001 vs. baseline). |
| Sano K, et al.[67]
|
2006 |
n = 140 |
Over a 30 +/- 7 month follow-up, 12 plaques caused ACS post-initial IVUS. Of these, 10 with baseline IVUS data were vulnerable plaques (VP), while the rest were stable plaques (SP; n = 143). VP had higher plaque burden, eccentricity, remodeling index, and percentage lipid area, and lower fibrous area than SP, despite no significant differences in vessel, lumen, or plaque areas. Sensitivity, specificity, and positive predictive values for percentage fibrous area (90%, 96%, and 69%, respectively) and percentage lipid area (80%, 90%, and 42%, respectively) were computed for VP classification. |
| Kataoka Y, et al.[68]
|
2012 |
n = 1,347 |
Patients with spotty calcification demonstrated a greater percent atheroma volume (PAV) (36.0 ± 7.6% vs. 29.0 ± 8.5%; P < 0.001) and total atheroma volume (174.6 ± 71.9 vs. 133.9 ± 64.9 mm3; P < 0.001). On serial evaluation, spotty calcification was associated with greater progression of PAV (0.43 ± 0.07% vs. 0.02 ± 0.11%; P = 0.002). |
| Uemura S, et al.[69]
|
2012 |
n = 53 |
Baseline characteristics of NSCPs were assessed using OCT, and patients were followed prospectively. During a 7-month follow-up, 13 NSCPs showed angiographic progression, while 56 did not. Progressing NSCPs exhibited significantly higher rates of intimal laceration, microchannels, lipid pools, thin-cap fibroatheroma (TCFA), macrophage images, and intraluminal thrombi compared to non-progressing NSCPs. Univariate regression analysis revealed strong correlations between TCFA and microchannel images with subsequent luminal progression (OR = 20.0, P < 0.01 for both). |
| Sakai K, et al.[71]
|
2019 |
n = 184 |
The IVUS-guided MINICON PCI group exhibited a significantly reduced contrast volume (22 ± 20 vs. 130 ± 105 mL; P < 0.0001) and contrast-induced acute kidney injury (CI-AKI; 2% vs. 15%; P = 0.001). The PCI success rate was similarly high (100% vs. 99%; P = 0.35). At 1 year (follow-up rate, 100%), there was less induction of RRT (2.7% vs. 13.6%; P = 0.01). All-cause mortality or myocardial infarction was similar in both groups. The IVUS-guided MINICON PCI reduces CI-AKI significantly and induction of RRT at 1 year in patients with stage 4 or 5 advanced CKD. |
| Sacha J, et al.[72]
|
2019 |
n = 20 |
Zero-PCI was feasible in each intended CKD patient, including those with complex left main stenosis or lesion within a saphenous vein graft, and there was no specific complication associated with this technique. Factual CI-AKI prevalence was 10% and no patient required renal replacement therapy. 75% of hemodialysis patients preserved their residual renal function. During the median follow-up of 3.2 (1.2–5.3) months, no patient experienced an acute coronary event or required revascularization. |
| Ali ZA, et al.[73]
|
2021 |
n = 31 |
31 patients with advanced CKD (creatinine = 4.2 mg/dL, IQR = 3.1–4.8, estimated GFR = 16 ± 8 mL/min/1.73 m²) underwent zero-contrast PCI with real-time IVUS guidance, confirming physiological improvement. This approach resulted in successful PCI, no major cardiovascular events, and preserved renal function (no RRT needed) during a median follow-up of 79 days (IQR = 33–207). |
| Srivastava A, et al.[77]
|
2022 |
n = 82 |
Primary outcome of CI-AKI occurred more in patients of the conventional PCI group [7 (17.1%)] than in the ULC PCI group [(0 patients), P = 0.012]. Contrast volume 41.02 ± 9.8 vs. 112.54 ± 25.18 mL; P < 0.0001) was markedly lower in the ULC-PCI group. No significant difference in secondary safety outcomes between two study arms at 30 days. IVUS was used in 17% patients in ULC PCI. |
| Liu ZY, et al.78
|
2021 |
n = 29 |
Ultra-low volume contrast PCI was performed after minimal contrast coronary angiography using zero contrast optical coherence tomography (OCT) guidance. The median creatinine level was 2.1 (inter-quartile range 1.8–3.3), and mean eGFR was 48 ± 8 ml/min/1.73 m2 pre-PCI. During the PCI procedure, OCT revealed 15 (52%) cases of abnormalities post-dilation. There was no significant change in the creatinine level and eGFR in the short- or long-term, and no major adverse events were observed. |
| Azzalani L, et al.[79]
|
2019 |
n = 111 |
Contrast volume (8.8 mL [interquartile range, 1.3–18.5 mL] vs. 90 mL [interquartile range, 58–140 mL]; P < 0.001) was markedly lower in the ULC-PCI group. Technical success was achieved in all ULC-PCI procedures; in 7 of the 8 cases (88%), the ULC-PCI protocol was also successful (contrast volume to eGFR ratio < 1). The incidence of CI-AKI was 0% vs. 15.5% in the ULC-PCI and conventional groups, respectively (P = 0.28). |
| Kurogi K, et al.[80]
|
2020 |
n = 1,183 |
Patients were assigned to undergo either OCT-guided PCI using LMWD or IVUS-guided PCI. There was no significant change from baseline in the primary endpoint, serum creatinine concentrations, after the procedure in either group. There were no significant differences between the OCT and IVUS groups in the volume of contrast medium, the incidence of contrast-induced nephropathy (1.5% vs. 2.3%; P = 0.65), and major adverse cardiovascular events (MACE) at 30 days (2.3% vs. 6.0%; P = 0.12) and 12 months (2.3% vs. 3.0%; P = 0.70) after the procedure. Kaplan-Meier analysis at the 12-month follow-up revealed no significant difference in the incidence of MACE between the 2 groups (P = 0.75). |
| Mahesh NK, et al.[81]
|
2020 |
n = 27 |
FD-OCT runs were categorized into three groups: good runs (GRs), clinically usable runs (CURs), and clinically not usable runs (NURs). GRs and CURs were combined as clinically effective runs (ERs). Saline FD-OCT allowed visualization of all coronary lesions. Out of the 118 runs analyzed, 88.1% were ERs, with 61% in the left coronary system (LCS) and 39% in the right coronary system (RCS). Among LCS runs, 86.2% were ERs, and among RCS runs, 91.3% were ERs. |
| Gupta A, et al.[82]
|
2022 |
n = 10 |
The saline OCT runs resulted in comparable MLA (3.88 ± 2.59 mm2 with saline run vs. 3.88 ± 2.71 mm2 with contrast run; P = 0.650), PRD (3.66 ± 0.52 mm with saline vs. 3.65 ± 0.52 mm with contrast; P = 0.463), DRD (2.97 ± 0.22 mm with saline vs. 2.99 ± 0.88 mm with contrast; p = 0.433), and AS (59.60 ± 18.62% with saline vs. 59.18 ± 19.11% with contrast; P = 0.753) with respect to the contrast runs. The Bland Altman plots of the measured parameters indicate good agreement between saline and contrast OCT. Using heparinized saline as flushing media in coronary FD-OCT resulted in vessel dimensions that are comparable with contrast. |
| Arora S, et al.[83]
|
2019 |
n = 56 |
IVUS evaluation confirms that an overwhelmingly large proportion of asymptomatic T2D patients have CAD. Overall, the prevalence of CAD defined by MIT ≥ 0.5 mm in the T2DM subjects was 84%, and as compared to the non-T2DM controls there was a significantly higher atheroma burden (mean MIT, PAV and TAV in the T2D population were 0.75 ± 0.27 mm, 33.8 ± 9.8% and 277.0 ± 137.3 mm3 as compared to 0.41 ± 0.19 mm, 17.8 ± 7.3% and 134.9 ± 100.6 mm3 in the reference population). |
| Rahman N, et al.[85]
|
2021 |
n = 134 |
IVUS utilization was higher in the LAD, n = 94 (70.1%), followed by LM, n = 46 (34.3%). The coronary artery dissection was noted in n = 15 (11.2%). MACEs were recorded in n = 13 (9.7%), which included heart failure, n = 4 (3%). Cardiovascular death and target vessel revascularization occurred in n = 3 (2.2%). Iatrogenic coronary dissection was zero. IVUS resulted in a significant decrease in MACE. |
| Kedhi E, et al.[87]
|
2021 |
n = 550 |
The primary endpoint compared FFR-negative TCFA-positive patients with FFR-negative TCFA-negative patients for a composite of cardiac mortality, target vessel myocardial infarction, clinically driven target lesion revascularization or unstable angina requiring hospitalization at 18 months. In diabetic patients with ≥ 1 FFR-negative lesions, TCFA-positive patients (25%) had a five-fold higher MACE rate, even without ischemia. |
| Fabris E, et al.[88]
|
2022 |
n = 390 |
In diabetic patients followed for 18 months, OCT differentiated between TCFA, ThCFA, and non-LRP within coronary lesions. TCFA had a much higher risk of future cardiovascular events (13.3%) compared to ThCFA (3.8%) and non-LRP (1.9%), which had similar and less concerning outcomes. In diabetic patients, TCFA lesions, though only one-third of LRP cases, predict high future risk, while LRP-ThCFA and non-LRP lesions have benign outcomes. |
| Khurwolah MR, et al.[89]
|
2018 |
n = 64 |
FD-OCT is more accurate than 2D-QCA for treating ICL stenosis in both OCT-guided PCI and OMT groups. No 30-day MACE incidents were observed in either group, and 12-month MACE and other clinical events were generally low, except for recurrent angina, which was similar in both groups. Notably, there were no MACE or clinical events in the subset of diabetic patients (n = 10). |
