Role of intravascular imaging in the evolution of percutaneous coronary intervention: a 30-year review

EuroIntervention Journal

It has been 40 years since percutaneous coronary intervention (PCI) was introduced into the clinical setting. Over these years significant advances in device technology and the invention of new therapeutic strategies have broadened its applications in the clinical arena, rendering this treatment the first-line therapy for patients with obstructive coronary artery disease.

The evolution of PCI would not have been possible without intravascular imaging which provided unique insights about coronary artery pathology, enabled evaluation of vessel wall response following PCI and allowed meticulous evaluation of the advantages and limitations of emerging devices. This review article appraises the role of intravascular imaging in the evolution of PCI, summarises the findings of invasive imaging studies that examined the efficacy of new therapies and endovascular devices, presents the evidence that supports its use in current clinical practice and discusses its future potential in PCI.

It has been 30 years since the introduction of intravascular ultrasound (IVUS), which for the first time enabled detailed assessment of coronary artery morphology and pathology. Even from the first applications of IVUS, it became apparent that intravascular imaging carries a unique potential in evaluating vessel wall response following percutaneous coronary intervention (PCI); therefore, over the last 30 years IVUS and, more recently, optical coherence tomography (OCT) have been extensively used to examine the extent and severity of coronary artery disease, guide PCI in complex lesions, and assess the performance of emerging devices introduced to treat coronary artery disease (CAD).

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Christos V. Bourantas, Erhan Tenekecioglu, Maria Radu, Lorenz Räber and Patrick W. Serruys