Evidence map›Paper›PMID 42410034›Full record

SynthesisCardiovascular and interventional radiology2026

Should Interventional Radiologists Incorporate Intravascular Ultrasound (IVUS) Into Their Daily Practice? A Systematic Review and Meta-Analysis of IVUS in Peripheral Arterial Endovascular Interventions.

Girija Agarwal, Rayan Kamal, Danial Saeed, Vasilis Stavrinides, Hutan Ashrafian, Nur Amalina Che Bakri, Taief Miah, Alun H Davies, Athanasios Saratzis, Raghu Lakshminarayan and 1 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Cardiovascular and interventional radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Girija AgarwalDepartment of Interventional Radiology, Imperial College Healthcare NHS Trust, Praed Street, London, W2 1NY, UK. girija178@gmail.com.ORCID http://orcid.org/0000-0001-8909-6560
Rayan KamalImperial College London Medical School, Ayrton Rd, South Kensington, London, SW7 5NH, UK.
Danial SaeedDepartment of Interventional Radiology, Imperial College Healthcare NHS Trust, Praed Street, London, W2 1NY, UK.
Vasilis StavrinidesDepartment of Interventional Radiology, Imperial College Healthcare NHS Trust, Praed Street, London, W2 1NY, UK.
Hutan AshrafianInstitute of Global Health Innovation, Imperial College London, South Kensington Campus, Faculty Building, South Kensington, London, SW7 2AZ, UK.
Nur Amalina Che BakriDepartment of Interventional Radiology, Imperial College Healthcare NHS Trust, Praed Street, London, W2 1NY, UK.
Taief MiahImperial College London Medical School, Ayrton Rd, South Kensington, London, SW7 5NH, UK.
Alun H DaviesDepartment of Surgery and Cancer, Section of Vascular Surgery, Imperial College London, Charing Cross Hospital, London, W6 8RF, UK.
Athanasios SaratzisNIHR Leicester Biomedical Research Centre, University of Leicester, Leicester, LE39QP, UK.
Raghu LakshminarayanDepartment of Interventional Radiology, Hull University Teaching Hospitals NHS Trust, Hull, HU3 2JZ, UK.
Mohamad HamadyDepartment of Interventional Radiology, Imperial College Healthcare NHS Trust, Praed Street, London, W2 1NY, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo provide a systematic review and meta-analysis of studies comparing intravascular ultrasound (IVUS)-guided versus angiography-guided peripheral vascular interventions (PVI) for peripheral arterial disease (PAD). MATERIALS AND

methodsWe performed a systematic review and meta-analysis, following PRISMA guidelines, of studies comparing IVUS-guided versus angiography-guided PVI for peripheral arterial disease (PAD). The study was registered in PROSPERO (CRD42024564731). Relevant databases were searched until Dec 2025. Eligible studies reported at least one of the following outcomes: amputation, all-cause mortality, target lesion revascularisation (TLR), restenosis/occlusion, major adverse limb events (MALE), or technical success. Random-effects models with inverse-variance weighting were used to generate pooled effect estimates.

resultsTwenty-five studies (23 observational, 2 randomised) including 1,110,593 patients (93,977 IVUS; 1,016,616 angiography) met inclusion criteria. Compared with angiography, IVUS guidance was associated with reduced rates of amputation (RR = 0.75, 95% CI for RR 0.61-0.93), all-cause mortality (RR = 0.86, 95% CI for RR 0.79-0.93), TLR (RR = 0.66, 95% CI for RR 0.48-0.91) and restenosis (RR = 0.74, 95% CI for RR 0.60-0.90). A numerically lower rate of major adverse limb events (MALE) was observed with IVUS guidance, although confidence intervals crossed the null effect (RR 0.66, 95% CI for RR 0.40-1.10). Technical success rates were similar between groups (RR 1.01, 95% CI for RR 1.00-1.01).

conclusionIVUS-guided PVI was associated with lower rates of amputation, TLR, restenosis, and all-cause mortality compared with angiography alone. However, the available evidence is predominantly observational with low-to-moderate certainty. These findings suggest potential benefit of IVUS-guided intervention in PAD, although further randomised controlled trials are needed.

Indexed as

Endovascular ProceduresPeripheral Arterial DiseaseUltrasonography, InterventionalAngiographyHumansEndovascularIVUSPeripheral arterial diseaseUltrasonography InterventionalVascular patency

Identifiers

PMID42410034

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.