Abstract Body (Do not enter title and authors here): Background: Although recent studies have suggested the advantages of utilizing optical coherence tomography (OCT) for image guidance during percutaneous coronary intervention (PCI) with drug-eluting stent implantation over conventional angiography, the specific impact on post-procedural lesion complications has remained uncertain. To address this gap, we conducted an updated systematic review and meta-analysis focusing on post-procedural lesion complications associated with OCT-guided versus angiography-guided procedures in lesions undergoing PCI with drug-eluting stent implementation.
Methods: We searched systematically through Pubmed, Embase, and Cochrane for randomized controlled trials(RCTs), which included lesions undergoing PCI and drug-stent deployment guided by OCTversus angiography. Our primary outcome of interest was (1) stent malposition under OCT analysis. We also included the following secondary outcome: (2) dissections under OCT analysis. We excluded studies that did not use OCT imaging to analyze post-procedure lesions. Risk Ratios(RRs) with 95% confidence interval (CI) were pooled across studies using a random effect model.
Results: Five RCTs comprising 3,266 lesions undergoing OCT or Angio PCI-guided and drug stent implementation were included, of whom 1,549(48,34%) underwent OCT. The number of moderate-severe calcified lesions was 370 (11.33%). Our results show a significant association with decreased stent malposition risk in the OCT group, showed a significant decrease in post-procedure risk regarding stent malpositioning ( RR: 0.80; 95% CI: 0.75-0.84; P<0.001; Fig.1) compared to angiography. However, our findings did not detect any difference in dissection undergoing OCT post-procedure analysis (RR: 1.58; 95% CI: 0.31- 8.06; P=0.583; Fig.2)., compared to the angiography group.
Conclusion: In this meta-analysis comparing OCT versus angiography in lesion complications post-procedure undergoing PCI and drug-stent implementation, the OCT group was associated with decreased stent malposition.