Rutten Lisa, Reijnen Stan E J, van de Velde Lennart, Versluis Michel, Reijnen Michel M P J
Multi-Modality Medical Imaging Group, TechMed Centre, University of Twente, Enschede, The Netherlands.
Department of Surgery, Rijnstate, Arnhem, The Netherlands.
Catheter Cardiovasc Interv. 2025 Aug;106(2):949-961. doi: 10.1002/ccd.31636. Epub 2025 May 29.
Performing adjunctive intravascular imaging during femoropopliteal endovascular intervention could improve treatment planning and outcome. This systematic review assessed how imaging findings of intravascular ultrasound (IVUS) and optical coherence tomography (OCT) can contribute to improving treatment planning and outcomes of patients with femoropopliteal arterial disease. Scopus and PubMed databases were searched from January 2011 to July 2023 for all studies reporting on the use of IVUS or OCT imaging findings in the treatment of femoropopliteal disease. The effect of IVUS and OCT imaging findings on treatment plan and outcome, as well as the predictive ability of IVUS and OCT for treatment outcome, were analyzed. A total of 42 studies (one randomized-controlled trial, 17 prospective, 20 retrospective, and four descriptive studies), 34 involving IVUS, seven OCT, and one both, were included. IVUS-assessed diameters were significantly larger, and lesion length was longer compared to angiography, which affected treatment planning. OCT-measured diameters were significantly larger than angiography at follow-up and did not differ significantly from IVUS except for one location. Both IVUS and OCT identified more dissections, calcifications, residual stenoses, and inadequate stent expansion than angiography, impacting treatment planning. IVUS-assessed imaging findings were associated with reduced restenosis at 1 and 2-year follow-up compared to angiography alone, while for OCT, data was limited. IVUS and OCT can visualize complementary imaging features compared to angiography alone that change the treatment plan of patients with femoropopliteal disease, both pre- and post-treatment. IVUS has the potential to improve treatment outcomes, whereas there is still limited evidence for OCT.
在股腘动脉血管腔内介入治疗期间进行辅助血管内成像可改善治疗规划并提高治疗效果。本系统评价评估了血管内超声（IVUS）和光学相干断层扫描（OCT）的成像结果如何有助于改善股腘动脉疾病患者的治疗规划和治疗效果。检索了Scopus和PubMed数据库在2011年1月至2023年7月期间发表的所有报告IVUS或OCT成像结果在股腘动脉疾病治疗中应用的研究。分析了IVUS和OCT成像结果对治疗方案和治疗效果的影响，以及IVUS和OCT对治疗效果的预测能力。共纳入42项研究（1项随机对照试验、17项前瞻性研究、20项回顾性研究和4项描述性研究），其中34项涉及IVUS，7项涉及OCT，1项同时涉及两者。与血管造影相比，IVUS评估的直径明显更大，病变长度更长，这影响了治疗规划。在随访时，OCT测量的直径明显大于血管造影，除一个部位外，与IVUS无显著差异。与血管造影相比，IVUS和OCT均发现了更多的夹层、钙化、残余狭窄和支架扩张不足，影响了治疗规划。与单纯血管造影相比，IVUS评估的成像结果与1年和2年随访时再狭窄的减少相关，而对于OCT，数据有限。与单纯血管造影相比，IVUS和OCT可以显示互补的成像特征，这会改变股腘动脉疾病患者治疗前和治疗后的治疗方案。IVUS有改善治疗效果的潜力，而OCT的证据仍然有限。
