NIRS-guided PCI: beyond calcium to precision PCI

Sponsored by ATC (Nipro)

Anchorperson: M. Alturki

Spokesperson: T. Roleder

Summary

This session explores how near-infrared spectroscopy (NIRS) is redefining PCI by revealing what angiography cannot see. By identifying lipid-rich and vulnerable plaques, NIRS helps anticipate procedural risk and refine decision-making before stent implantation. The session shows how plaque composition, rather than calcium alone, can guide lesion preparation strategies, support safer stent positioning, and improve expansion. Through practical examples, it highlights how integrating NIRS with intravascular imaging and physiology moves PCI toward a more targeted, data-driven, and truly precision-based approach.

Learning Objectives

To identify vulnerable plaques: NIRS detects lipid-rich plaques that are invisible to angiography. This allows interventionalists to anticipate complications like distal embolisation or no-reflow and adjust their approach accordingly
To optimise lesion preparation: when NIRS reveals high lipid burden or calcific nodules, operators can choose atherectomy, intravascular lithotripsy, or specialised balloons to modify the lesion before stenting
To improve stent placement and expansion: NIRS-IVUS guidance ensures stents are deployed in stable segments, avoiding lipid-rich or heavily calcified areas that may compromise expansion or healing

Speaker

M. Alturki

Welcome and session objectives