Richard A and Susan F Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Division of Cardiology, New York University Grossman School of Medicine, New York, NY, USA.
Vasc Med. 2022 Aug;27(4):392-400. doi: 10.1177/1358863X221092817. Epub 2022 May 12.
Although angiography has been the primary imaging modality used in peripheral vascular intervention, this technique has major limitations due to the evaluation of three-dimensional vessels in two dimensions. Intravascular ultrasound (IVUS) is an important adjunctive tool that can address some of these limitations. This systematic review assesses the appropriateness of IVUS as an imaging modality for guiding peripheral intervention through evidence collection and clinical appraisal of studies. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a cohort of 48 studies (29 arterial; 19 venous) detailing IVUS use in peripheral vascular intervention were extracted. Qualitative assessment of the studies evaluated pre- and postprocedure efficacy of IVUS and revealed that IVUS-guided peripheral intervention in arterial and venous diagnosis and treatment was superior to other imaging techniques alone. Each study in the cohort was further assessed for reliability and validity using the Oxford Centre for Evidence Based Medicine (CEBM) level of evidence scale. The majority of both arterial (79.3%) and venous (73.7%) studies received a 2b rating, the second highest level of evidence rating. The evidence to date indicates that IVUS results in better clinical outcomes overall and should be more widely adopted as an adjunctive imaging modality during peripheral intervention. .
虽然血管造影术一直是外周血管介入的主要成像方式，但由于只能在二维平面上评估三维血管，因此该技术存在很大的局限性。血管内超声（IVUS）是一种重要的辅助工具，可以解决其中的一些局限性。本系统评价通过对研究的证据收集和临床评估，评估 IVUS 作为外周介入成像方式的适宜性。根据系统评价和荟萃分析的首选报告项目（PRISMA）指南，共提取了 48 项研究（29 项动脉；19 项静脉），详细描述了 IVUS 在外周血管介入中的应用。对研究的定性评估评估了 IVUS 在动脉和静脉诊断和治疗前后的疗效，并表明 IVUS 引导的外周介入在动脉和静脉诊断和治疗方面优于其他单独的成像技术。使用牛津循证医学中心（CEBM）证据等级量表对队列中的每个研究进一步评估了可靠性和有效性。大多数动脉（79.3%）和静脉（73.7%）研究的评分均为 2b，这是第二高的证据评分。迄今为止的证据表明，IVUS 总体上可带来更好的临床结果，应更广泛地将其作为外周介入的辅助成像方式。
