Table 1.
Characteristics of the included studies
| Study | Year of publication | No. of centers | Country | Group 1 (intravascular imaging-guided) | Group 2 (coronary-guided angiography) | Longest follow-up duration | Inclusion criteria | Primary outcome | Stent type |
|---|---|---|---|---|---|---|---|---|---|
| HOME DES IVUS | 2010 | Single-center | Czech Republic | 105 | 105 | 18 months | Complex coronary lesions or complex patient characteristics such as type B2 and C according to the American Heart Association, proximal left anterior descending artery, left main disease, reference vessel diameter < 2.5 mm, lesion length > 20 mm, in-stent restenosis, insulin-dependent diabetes mellitus, and acute coronary syndrome were included in this study | To assess the role of IVUS guidance during implantation of DES on long-term outcome in patients with high clinical and angiographic | CYPHER (sirolimus-eluting stents) and TAXUS (paclitaxel-eluting stents) |
| Kim et al. [23] | 2013 | Multicenter | South Korea | 269 | 274 | 12 months | Age > 20 years and had a de novo lesion requiring a stent ≥ 28 mm in length in a vessel with a distal reference diameter ≥ 2.5 mm by visual angiographic estimation | MACE | Endeavor Sprint zotarolimus-eluting stents (E-ZES) or everolimus-eluting stent (EES) (Xience V, Abbott Vascular, Santa Clara, California) |
| AVIO | 2013 | Multicenter | Italy | 142 | 142 | 24 months | Complex lesions defined as one of the following: long length (> 28 mm); CTO, i.e., a total occlusion of duration more than 3 months; lesions involving a bifurcation; small vessels (≤ 2.5 mm) and patients requiring 4 or more stents | Post-procedure in lesion minimal lumen diameter | DES |
| AIR-CTO | 2015 | Multicenter | China | 115 | 115 | 2 years | Patients aged 18–80 years, who had at least one CTO lesion (defined as TIMI grade 0 and occlusion duration > 3 months) that had been successfully recanalized (defined as a wire-crossed CTO lesion and at the distal true lumen according to angiograms) | In-stent late lumen loss at 1-year follow-up | Either first- or second-generation DES |
| Tan et al. [22] | 2015 | Single-center | China | 61 | 62 | 2 years | Unprotected left main coronary artery, defined as at least 50% stenosis by visual assessment in the LM vessel without bypass grafts to the left anterior descending artery or left circumflex artery | MACE | Sirolimus-eluting stents (Firebird-2, Microport, Shanghai, China) or sirolimus-eluting stents (Excel, Jiwei, Shandong, China) |
| CTO-IVUS | 2015 | Multicenter | South Korea | 201 | 201 | 12 months | Patients with CTO who were aged 20–80 years and had typical symptomatic angina or positive test results for functional evaluation of ischemia | Cardiac death | Zotarolimus-eluting stents or Nobori biolimus-eluting stents |
| Liu et al. [24] | 2019 | Single-center | China | 167 | 169 | 12 months |
Adults, aged 18–75 years Unprotected left main coronary artery lesions and plan for DES implantation |
MACE, defined as cardiac death, MI, or TVR | DES |
| IVUS-XPL | 2020 | Multicenter | South Korea | 700 | 700 | 5 years | Patients with typical chest pain or evidence of myocardial ischemia were eligible for enrollment if implantation of an everolimus-eluting stent for a long coronary lesion (implanted stent ≥ 28 mm in length) was indicated on the basis of angiographic lesion length estimation | MACE, defined as cardiac death, target lesion-related MI, or ischemia-driven TLR at 5 years | Everolimus-eluting stent |
| ULTIMATE | 2021 | Multicenter | China | 724 | 724 | 3 years | Patients with silent ischemia, stable or unstable angina, or MI with more than 24 h between onset of chest pain and admission and de novo coronary lesions requiring DES implantation | TVF at 3 years after the index procedure, including cardiac death, target vessel MI, and clinically driven TVR | Second-generation DES |
| RENOVATE-COMPLEX-PCI | 2023 | Multicenter | South Korea | 1092 | 547 | 3 years | Patients 19 years of age or older who were undergoing PCI for complex coronary artery lesions, defined as true bifurcation lesions according to the Medina classification system with a side-branch diameter of at least 2.5 mm; a chronic total occlusion; unprotected left main coronary artery disease; long coronary artery lesions that would involve an expected stent length of at least 38 mm; multivessel PCI involving at least two major epicardial coronary arteries being treated at the same time; a lesion that would necessitate the use of multiple stents (at least three planned stents); a lesion involving in-stent restenosis; a severely calcified lesion; or ostial lesions of a major epicardial coronary artery | TVF, defined as the composite of death from cardiac causes, target vessel-related MI, or clinically driven TVR | Polymer-coated everolimus-eluting stents |
IVUS intravascular ultrasound, DES drug-eluting stent, CTO chronic total occlusion, MI myocardial infarction, MACE major adverse cardiac events, TLR target lesion revascularization, TVF target vessel failure, TVR target vessel revascularization, PCI percutaneous coronary intervention, TIMI thrombolysis in myocardial infarction, LM left main