Imaging in Coronary Interventions

Coronary angiography has historically served as the gold standard for diagnosis of coronary artery disease and guidance of percutaneous coronary intervention (PCI), but the evolution of PCI would not have been possible without intravascular imaging which provides unique insights about coronary artery pathology.

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 (CAD), guide PCI in complex lesions, and assess the performance of emerging devices introduced to treat CAD. In this section, you will find a selection of resources showing the use of imaging in real-life scenarios.

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Double barrel in CTO PCI

23 Apr 2024

This EIJ image illustrates a crucial case, emphasizing the importance of confirming wire position in the true lumen during dissection and re-entry techniques in CTO PCI.

Double barrel in CTO PCI

Quantitative coronary angiography vs intravascular ultrasonography to guide drug-eluting stent implantation - a randomized clinical trial

21 Mar 2024

The trial aimed to establish the non-inferiority of QCA-guided PCI compared to IVUS-guided PCI with respect to the primary endpoint of TLF at 12 months, defined as a composite of cardiac death, target vessel MI, or ischemia-driven target lesion revascularization.

Giovanni Occhipinti

Reviewer

Giovanni Occhipinti

Reviewer

Salvatore Brugaletta
QCA vs IVUS to guide DES implantation - a randomized clinical trial

How to perform angiographic check after large-sheath removal in single access procedures

18 Mar 2024

In the absence of other arterial access, this step-by-step tutorial shows how to perform anterograde angiography of the arterial axis after removal of the large sheath, making it easier to recognise and rapidly manage vascular complications such as arterial lesions and haemostasis failure.

Francesco Burzotta

Author

Francesco Burzotta
Lazzaro Paraggio

Author

Lazzaro Paraggio
Mattia Lunardi

Author

Mattia Lunardi
Cristina Aurigemma

Author

Cristina Aurigemma
Enrico Romagnoli

Author

Enrico Romagnoli

Author

Francesco Fracassi

Author

Antonino Buffon
C. Trani

Author

Carlo Trani
How to perform angiographic check after large-sheath removal in single access procedures

"My Take on OCT Trials" by Davide Capodanno: CRT 2024

19 Mar 2024

View a series of commented slides illustrating major takeaways from a network meta-analysis of Coronary Angiography, Intravascular Ultrasound, and Optical Coherence Tomography in the Guidance of Percutaneous Coronary Intervention. These slides and comments were originally shared via Twitter upon the occasion of the 2024 Cardiovascular Research...

Author

Davide Capodanno
'My Take on OCT Trials' by Davide Capodanno at CRT 2024

Intravascular ultrasound-guided versus angiography-guided percutaneous coronary intervention in acute coronary syndromes: The multicenter, randomized, blinded, IVUS-ACS Trial

09 Apr 2024

Marco Spagnolo and Daniele Giacoppo report the main results of the IVUS-ACS trial presented by Shao-Liang Chen, from the Nanjing First Hospital, Nanjing Medical University, Nanjing, in a Featured Clinical Research session at ACC.24 in Atlanta and simultaneously published in The Lancet.(1)

Daniele Giacoppo

Author

Daniele Giacoppo
Marco Spagnolo

Author

Marco Spagnolo
IVUS-guided vs angiography-guided PCI in acute coronary syndromes

Ultra-low contrast techniques in complex and high-risk coronary interventions

07 Dec 2023 – From GulfPCR-GIM 2023

Explore this session to gain insights into reducing operator reliance on contrast in PCI for enhanced safety and quality, particularly in complex scenarios. Discover essential tips, tricks, and specialized tools tailored for ultra-low-contrast PCI. Additionally, immerse yourself in a practical, step-by-step example through a recorded ultra-low-contrast...

Ultra-low contrast techniques in complex and high-risk coronary interventions

OCT-guided PCI for a patient with calcified lesion

07 Dec 2023 – From GulfPCR-GIM 2023

Consult this session to gain insights into the significance of actionable intracoronary imaging in the patient treatment journey and acquire knowledge on adopting procedural strategies. Learn about the effective utilisation of orbital atherectomy for plaque modification and the impact of DES platforms in the management of...

OCT-guided PCI for a patient with calcified lesion

Guiding intervention for complex coronary lesions by optical coherence tomography or intravascular ultrasound

06 Nov 2023

The OCTIVUS trial was a prospective multicentre, open-label, randomised controlled trial comparing OCT guided PCI with IVUS guided PCI. In this pre-specified sub-study, the authors report the outcomes in patients with complex coronary lesions undergoing OCT- or IVUS-guided PCI. 

Nicola Ryan

Reviewer

Nicola Ryan
Guiding intervention for complex coronary lesions by OCT or IVUS

The unimaginable evolution of interventional cardiology from imagination to imaging

07 Nov 2023

Faith is to believe what you do not see; the reward of this faith is to see what you believe... Read this editorial by Flavio Ribichini, Martine Gilard and Salvatore Brugaletta which introduces this section dedicated to cardiovascular imaging. ...

The unimaginable evolution of interventional cardiology from imagination to imaging

OCTIVUS: OCT- vs. IVUS-Guided PCI

27 Aug 2023

Ali Nazmi Calik interviews Duk-Woo Park & Do-Yoon Kang regarding the results of the OCTIVUS trial which were presented during the ESC Congress 2023 in Amsterdam.

Key message is that optical coherence tomography (OCT) is non-inferior to intravascular ultrasound (IVUS) for guiding percutaneous coronary intervention (PCI).

Author

Ali Nazmi Calik

Author

Do-Yoon Kang
OCTIVUS: OCT- vs. IVUS-Guided PCI