title: Does intravascular ultrasound provide clinical benefits for percutaneous coronary intervention with bare-metal stent implantation? A meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  The role of intravascular ultrasound (IVUS) in percutaneous coronary interventions (PCI) is still controversial despite several previously published meta-analyses. A meta-analysis to evaluate the controversial role of IVUS-guided PCI with bare-metal stenting was performed and a previous published meta-analysis was re-evaluated in order to clarify the discrepancy between results of these studies.
  
  
  METHODS
  A systematic review was performed by an electronic search of the PubMed, Embase and Web of Knowledge databases and by a manual search of reference lists for randomized controlled trials published until April 2011, with clinical outcomes and, at least, six months of clinical follow-up. A meta-analysis based on the intention to treat was performed with the selected studies.
  
  
  RESULTS
  Five studies and 1,754 patients were included. There were no differences in death (OR = 1.86; 95% CI = 0.88-3.95; p = 0.10), non-fatal myocardial infarction (OR = 0.65; 95% CI = 0.27-1.58; p = 0.35) and major adverse cardiac events (OR = 0.74; 95% CI = 0.49-1.13; p = 0.16). An analysis of the previous published meta-analysis strongly suggested the presence of publication bias.
  
  
  CONCLUSIONS
  There is no evidence to recommend routine IVUS-guided PCI with bare-metal stent implantation.  This may be explained by the paucity and heterogeneity of the studies published so far.
authors.affiliation: Instituto de Avaliação de Tecnologias em Saúde (IATS), do Hospital das Clínicas da Universidade Federal de Minas Gerais (UFMG), Avenida Alfredo Balena, 110, CEP, 30130-100, Belo Horizonte, MG, Brazil. lucaslodi@yahoo.com.br
authors.forename: Lucas
authors.initials: L
authors.lastname: Lodi-Junqueira
authors.forename: Marcos Roberto
authors.initials: MR
authors.lastname: de Sousa
authors.forename: Leonardo Carvalho
authors.initials: LC
authors.lastname: da Paixão
authors.forename: Silvana Márcia Bruschi
authors.initials: SM
authors.lastname: Kelles
authors.forename: Carlos Faria Santos
authors.initials: CF
authors.lastname: Amaral
authors.forename: Antonio L
authors.initials: AL
authors.lastname: Ribeiro
mesh_terms: D006801:Humans; D062645:Percutaneous Coronary Intervention; D016032:Randomized Controlled Trials as Topic; D015607:Stents; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional