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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From imaging to intervention: cutting-edge solutions for calcified coronary stenoses management

20 May 2025 – From EuroPCR 2025

Watch this EuroPCR 2025 session on managing calcified coronary stenoses, featuring a recorded live case, two focused lectures, and expert faculty insights. Learn why intravascular ultrasound (IVUS) is essential for assessing lesion severity and morphology, discover how selecting the right calcium modification tools drives procedural success...

From imaging to intervention: cutting-edge solutions for calcified coronary stenoses management

Benefits of IVUS plus near-infrared spectroscopy in detecting and managing vulnerable plaques

21 May 2025 – From EuroPCR 2025

At EuroPCR 2025, Nilesh Pareek and Thomas Keeble discuss the clinical value and future potential of NIRS IVUS, a dual-modality imaging system developed by Nipro that combines intravascular ultrasound with near-infrared spectroscopy.

The Makoto™ system and Dualpro™ catheter allow real-time identification of lipid-rich plaques by providing both...

Benefits of IVUS plus near-infrared spectroscopy in detecting and managing vulnerable plaques

How to manage treatment dilemmas in STEMI patients with multivessel disease?

20 May 2025 – From EuroPCR 2025

Managing STEMI patients with multivessel disease is a complex challenge evolving rapidly thanks to new clinical evidence. Angela Mcinerney, Natalia Pinilla, and Matthias Götberg explore how findings from the COMPLETE trial and its intracoronary imaging substudy are reshaping treatment strategies.

Their discussion highlights the role of intracoronary...

How to manage treatment dilemmas in STEMI patients with multivessel disease?

What are the fundamentals of an upfront two-stent strategy for bifurcation PCI?

21 May 2025 – From EuroPCR 2025

Nicola Ryan explores the fundamentals of an upfront two-stent strategy in bifurcation PCI with Dejan Milasinovic. When the side branch shows significant, high-grade stenosis or extensive disease, direct treatment - via POBA, DCB, or a second stent - may be preferred. Anatomy guides the decision between...

What are the fundamentals of an upfront two-stent strategy for bifurcation PCI?

Calcium is not a rocket science

07 May 2025

We present the case of an 83-year-old man admitted with chronic coronary syndrome.

Coronary angiography revealed critical long calcified LAD stenosis. Complex PCI with different plaque modification techniques and intravascular imaging guiding was necessary to reach the success.

Piotr Kubler

Author

Piotr Kubler
Wojciech Zimoch

Author

Wojciech Zimoch
Wiktor Kuliczkowski

Author

Wiktor Kuliczkowski
Krzysztof Reczuch

Author

Krzysztof Reczuch
Calcium is not a rocket science

Complex PCI for severely calcified, uncrossable RCA lesion

07 Apr 2025

A 72-year-old male patient with stable coronary artery disease was admitted for recurrence of angina (CCS II/III). Coronary angiography revealed significant stenosis in the mid-portion of RCA. Ad hoc PCI of RCA was unsuccessful due to an uncrossable lesion...

Michal Hawranek

Author

Michal Hawranek
Lukasz Pyka

Author

Lukasz Pyka
Complex PCI for severely calcified, uncrossable RCA lesion

Rotational atherectomy, lithotripsy, or laser for calcified coronary stenosis: the ROLLER COASTR-EPIC22 trial

24 Mar 2025

Due to a lack of randomised evidence, this randomised controlled trial (RCT) aimed to compare the safety and efficacy of IVL and ELCA with RA in treating heavily calcified coronary lesions before drug-eluting stent implantation.

Reviewer

Ali Nazmi Calik

Reviewer

Aaysha Cader
Rotational atherectomy, lithotripsy, or laser for calcified coronary stenosis: the ROLLER COASTR-EPIC22 trial

Can’t stand heavy metal: how to treat an ACS with severe metal allergy?

17 Mar 2025

Francesco Costa

Author

Francesco Costa

Author

Antonio Muñoz Garcia
Alberto Piserra

Author

Alberto Piserra

Author

Juan Horacio Alonso Briales
Can’t stand heavy metal: how to treat an ACS with severe metal allergy?

Impact of intravascular imaging guidance on percutaneous coronary intervention of severely calcified lesions: The ECLIPSE trial

29 Mar 2025

Aaysha Cader provides her take on the ECLIPSE trial presented by Gregg W. Stone at ACC.25 in Chicago.

Author

Aaysha Cader
Impact of intravascular imaging guidance on percutaneous coronary intervention of severely calcified lesions: The ECLIPSE trial

Functional or anatomical assessment of non-culprit lesions in acute myocardial infarction

06 Mar 2025

This study demonstrates that OCT-defined TCFA is a superior prognostic marker compared to μQFR for assessing NCLs in AMI patients.

Alessandro Sticchi

Reviewer

Alessandro Sticchi
Functional or anatomical assessment of non-culprit lesions in AMI