Abstract 11770: Clinical Outcomes of Optical Coherence Tomography-Guided Compared With Intravascular Ultrasound-Guided in Low-Risk Percutaneous Coronary Intervention: A Meta-Analysis

Background: Axial resolution provided by optical coherence tomography (OCT) is 10 times higher compared with intravascular ultrasound (IVUS), hence OCT could detect fine details such as edge dissections and tissue coverage of stent struts which may be missed by IVUS imaging. Given the lack of robust comparative data, utilization of IVUS or OCT in PCI guidance is mainly based on the operator experience. Recently, multiple studies have compared clinical outcomes between OCT-guided versus IVUS-guided in PCI, thus we performed this meta-analysis. Methods: We conducted a meta-analysis of all studies evaluating the clinical outcomes of OCT-guided versus IVUS-guided in low-risk PCI. Studies that included patients with left main disease, bifurcation lesions, long lesions, in-stent stenosis, and patients with history of coronary artery bypass grafting were all excluded. Our primary outcome was major cardiac adverse events (MACE). Secondary outcomes consisted of all-cause death, myocardial infarction (MI), stent thrombosis (ST), and target lesion revascularization (TLR). Results: Four RCTs and one propensity-matched observational study were included, with a total of 1,544 patients and a median weighted follow-up period of 1.26 years. Out of the total population, 51% were in the OCT arm and 49% in the IVUS arm. Our pooled analysis showed a similar risk of MACE (OCT 5.0% vs IVUS 4.7%, p=0.90), risk of all-cause death (OCT 2.7% vs IVUS 1.7%, p=0.44), MI (OCT 1.5% vs IVUS 1.3%, p=0.76), ST (OCT 0.3% vs IVUS 0.4%, p=0.66) and TLR (OCT 2.2% vs IVUS 2.6%, p=0.58) between the two groups (Figures 1). Heterogeneity was low in all outcomes (I 2 =0). Conclusion: OCT-guided PCI has similar long term clinical outcomes when compared to IVUS-guided PCI in low-risk patients. RCTs with a larger population and longer follow-up periods are needed to confirm these results.