[Intravascular ultrasound in coronary artery disease]

Klappenbach R, Ciapponi A, Pichon-Riviere A, Augustovski F, García Martí S, Alcaraz A, Bardach A.
Record ID 32018001568
Spanish
Original Title: Ultrasonografía intravascular en coronariopatía
Authors' recommendations: High-quality evidence shows that intravascular ultrasound (IVUS) considerably decreases major adverse cardiac events and improves revascularization of the lesion when compared with coronary angiography as guidance for coronary stent placement in complex stenosis (e.g., in the left main coronary artery, long stenoses). It also reduces cardiac mortality and myocardial infarction when guiding drug-eluting stent placement. Low-quality evidence suggests that there would not be differences in clinical outcomes between IVUS and optical coherence tomography as guidance for coronary stent placement. Very low-quality evidence does not allow to draw conclusions on the risks and benefits of the use of IVUS as guidance for coronary stents in non-complex stenosis. Low-quality evidence on the use of IVUS compared with the fractional flow reserve in diagnosing intermediate coronary stenoses that would require revascularization or not, suggests that there would not be differences in clinical outcomes or diagnostic accuracy. Very low-quality evidence does not allow to determine the risks or benefits of the use of IVUS in diagnosing heart graft vascular disease. High-quality evidence shows that IVUS is a safe practice with a low rate of adverse events. The clinical practice guidelines surveyed recommend the use of IVUS, both as guidance during stent placement and to diagnose intermediate (40-70%) stenosis of the coronary trunk, the cause of restenosis and heart graft valve disease. The health systems of Brazil and Colombia as well as some US insurance companies cover the use of this technology. The cost-effectiveness of IVUS is unknown, although there are economic evaluations from high-income countries suggesting it might be cost-saving in coronary stent placement.
Details
Project Status: Completed
Year Published: 2020
URL for published report: https://www.iecs.org.ar/home-ets/
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Argentina
MeSH Terms
  • Coronary Artery Disease
  • Ultrasonography
  • Coronary Angiography
  • Ultrasonography, Interventional
  • Cardiovascular Diseases
  • Coronary Restenosis
  • Stents
Contact
Organisation Name: Institute for Clinical Effectiveness and Health Policy
Contact Address: Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA
Contact Name: info@iecs.org.ar
Contact Email: info@iecs.org.ar
Copyright: Institute for Clinical Effectiveness and Health Policy (IECS)
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