Outcomes of Optical Coherence Tomography Compared with Intravascular Ultrasound to Guide Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis of Randomized Control Trials

Abstract

In the recent years, the alternative intravascular imaging modalities that are most frequently employed to direct and optimize PCI have been intravascular ultrasound (IVUS) and optical coherence tomography (OCT). The comparative effectiveness of OCT-guided vs IVUS-guided PCI is still up for debate. The purpose of this study was to conduct a systematic review and meta-analysis of all available studies comparing OCT-guided versus intravascular ultrasound (IVUS)-guided PCI. Electronic journals searching were performed in PubMed, ScienceDirect, and Cochrane from January 2015 to March 2023 to identify randomized control trial (RCT) studies that compare OCT‐guided PCI to IVUS‐guided PCI. Meta-analyses were performed on included studies and Odds ratio (OR) and 95% Confidence Interval (CI) were estimated using Review Manager v5.4. A total of four RCT enrolling 1316 participants were included in our analysis. There is no statistical significance was observed in the OCT versus IVUS comparison on all cause mortality [OR = 1.75, 95% CI (0.52, 5.88), p = 0.37], cardiovascular mortality [OR = 1.40, 95% CI (0.27, 7.11), p = 0.69], MACE [OR = 1.04, 95% CI (0.63, 1.71), p = 0.88], ST [OR = 0.94, 95% CI (0.16, 5.52), p = 0.95], TLR [OR = 0.77, 95% CI (0.39, 1.50), p = 0.44], and TVR [OR = 1.19, 95% CI (0.68, 2.07), p = 0.54].