Intravascular ultrasound-guided interventions in coronary artery disease: a systematic literature review, with decision-analytic modelling, of outcomes and cost-effectiveness

Berry E, Kelly S, Hutton J, Lindsay HS, Blaxhill JM, Evans JA, Connelly J, Tisch J, Walker GC, Sivananthan UM, Smith MA
Record ID 32001000004
English
Authors' objectives:

1. To identify the literature on intravascular ultrasound (IVUS) for guiding coronary interventions, and to synthesise evidence about outcomes compared with outcomes when IVUS guidance has not been used.

2. To use this evidence, together with other information about costs and outcomes, to model the cost effectiveness of IVUS guidance.

3. To synthesise the evidence on the reproducibility of measurements of cross-sectional area made using IVUS.

Authors' results and conclusions: Only one study on IVUS-guided angioplasty satisfied the inclusion criteria, and there were no studies on IVUS-guided atherectomy or other IVUS-guided interventions that satisfied the inclusion criteria. Of the 15 articles on IVUS-guided stenting that satisfied the inclusion criteria, seven presented data on outcomes at 6 months post-intervention. The angiographic restenosis rate was 16 +/-1%. This compared with 24 +/-2% derived from five articles on stenting without IVUS guidance. Data for follow-up periods longer than 6 months were presented in only two studies. The smallest changes in cross-sectional area that could be measured were 1.6 mm2 by a single observer and 1.9 mm2 by different observers.
Authors' recomendations: The evidence available is too weak for there to be any reliable implications for clinical practice.
Authors' methods: Systematic review
Details
Project Status: Completed
URL for project: http://www.hta.ac.uk/1066
Year Published: 2000
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: England, United Kingdom
MeSH Terms
  • Costs and Cost Analysis
  • Ultrasonography, Interventional
  • Coronary Disease
Contact
Organisation Name: NIHR Health Technology Assessment programme
Contact Address: NIHR Journals Library, National Institute for Health and Care Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK
Contact Name: journals.library@nihr.ac.uk
Contact Email: journals.library@nihr.ac.uk
Copyright: 2000 Queen's Printer and Controller of HMSO
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.