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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Complex bifurcation PCI - LIVE case

17 May 2023 – From EuroPCR 2023

Study the case of this 69-year-old male patient with recent PCI on LAD presenting chronic coronary syndrome. Angiography showed calcified stenosis on bifurcation of proximal CX and large obtuse marginal 1, Medina 0-1-1.

The PCI strategy was an OCT-guided TAP technique: 

7F guiding catheter, predilatation with semi-compliant and non-compliant...

Complex bifurcation PCI - LIVE case

Rethinking PCI in left main: OCT-guided optimisation

17 May 2023 – From EuroPCR 2023

Discover the transformative role of optical coherence tomography (OCT) in optimizing left main percutaneous coronary intervention (PCI) in this session. Gain insights into how OCT can guide the step-by-step process of left main PCI to achieve optimal results, and explore the crucial parameters of procedural outcome,...

Rethinking PCI in left

Third generation OCT (HF-OCT): no more limits to the routine clinical use of intravascular imaging

17 May 2023 – From EuroPCR 2023

Imaging is critical to strategy management. If you want to get a sense of the contributions of HF-OCT in clinical routine, listen to the speakers talk about their real-world experience and learn from their case presentations.

Third generation OCT

The PECTUS trial, OCT for identification of vulnerable plaques and its impact on clinical outcomes

16 May 2023 – From EuroPCR 2023

Niels Van Royen and Lorenz Räber discuss a very emerging topic: the vulnerable plaque, and more specifically the related PECTUS Trial. They address the question of why vulnerable plaques should be detected and what can be done with the results, before looking at the study design...

The PECTUS trial, OCT

A patient with NSTEMI and multivessel disease: culprit and non-culprit lesion management

16 May 2023 – From EuroPCR 2023

Follow the discussion around 2 specific cases, a 72-year-old ex-smoker female patient with HTN, hyperlipidemia, previous TIA, COPD and stable lung cancer, and a 44-year-old male patient with T2DM, HTN, dyslipidemia, psoriasis and chest pain, and learn how to treat NSTEMI with MVD.

A patient with NSTEMI and multivessel disease: culprit and non-culprit lesion management

Management of complex non-culprit multivessel disease after STEMI - LIVE case

16 May 2023 – From EuroPCR 2023

Analyze the case of a 69-year-old non-diabetic male patient with mild chronic kidney disease, acute inferior MI and primary PCI on the postero-lateral RCA, whose angiography showed diffuse disease on the proximal CX and second OM (QFR: 0.65), and an intermediate prox LAD lesion (QFR: 0.90).

IVUS...

Management of complex non-culprit MVD after STEMI - LIVE case

Distal left main stenosis with a trifurcation - LIVE case

16 May 2023 – From EuroPCR 2023

Watch the case of a 69-year-old male patient with atrial fibrillation, peripheral artery disease and severe pulmonary disease, referred for worsening angina. The angiography revealed a tight distal left main stenosis on a trifurcation.

In this case, the PCI is guided by IVUS with provisional stenting (LM-LAD) and protect...

Distal left main stenosis with a trifurcation - LIVE case

Planning of CTO PCI based on initial angiogram

16 May 2023 – From EuroPCR 2023

View the case of a man with severe inferior ischemia and right coronary occlusion at the proximal and mi-parts, & follow discussion about how to approach the CTO, before analyzing the one of a 62-year-old man with anterior STEMI and elective PCI Cx, HTN, hyperlipidemia, LVEF...

Planning of CTO PCI based on initial angiogram

How can you determine the culprit lesion in NSTEMI?

16 May 2023 – From EuroPCR 2023

Since patients with NSTEMI represent an important population in practice, Ziad Ali and Natalia Pinilla discuss the diagnosis of culprit lesions in such patients. The first tool to rely on is intravascular imaging, even if imaging does not yet allow the interpretation of ambiguous or residual lesions....

How can you determine the culprit lesion in NSTEMI?

Results from the DCR4Contrast (Dynamic Coronary Roadmap for Contrast reduction) Trial

16 May 2023 – From EuroPCR 2023

Javier Escaned joins Ajay Kirtane to discuss the DCR4C Trial he conducted, and more specifically to present the main results.

The framework of the study was the contrast reduction during PCI, which is closely related to what is now known as ultra-low contrast PCI, and which mainly concerns particularly...

Results from the DCR4Contrast