Safety, Effectiveness and Cost-effectiveness of Intravascular Ultrasound in Comparison with Invasive Angiography: a Rapid Health Technology Assessment

Intravascular imaging is the tool for the detection of coronary artery atherosclerosis in the coronary intervention procedure as the supplement of invasive angiography plays the major role in determining the degree of vessel stenosis and plaque pathology.
For retrieving second type studies, the Cochrane Library and Centre for Review and Dissemination (CRD) were searched. Studies which compared intravascular ultrasound technology with invasive angiography were included. Results of included studies were synthesized via qualitative method.
According to included studies the rate of target lesion revascularization after one year of follow-up, reported a statistically significant difference between intravascular ultrasound and angiography invasive alone, it seems that the rate of TLR was lower with intravascular ultrasound (P = 0/02). In terms of cost effectiveness, per prevented TLR, 0.48 QALY was obtained, which indicates a savings of 54, 000 US dollars per QALY.
Although intravascular ultrasound could be able to detect the damages of coronary arteries and will be aided physician in selecting the most appropriate treatment, but due to the high cost of an ultrasound catheter intravascular, the invasive angiography, coronary intervention is the choice of doctors and disease. It is suggested according to the cost savings per obtained QALY from prevented TLR, the use of intravascular ultrasound in coronary interventions, at least for the younger age group should be considered.