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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Stepwise OCT for treatment optimization in provisional approach of bifurcated coronary lesions

10 Jan 2025

OCT provides information of the accuracy of every maneuver performed during the treatment of bifurcation lesions. We can clearly see if the POT achieves proximal stent apposition, if the side branch wire crosses through the correct cell, and the impact of final kissing-balloon inflation on stent geometry.

Javier Suarez de Lezo

Author

Javier Suarez de Lezo
Stepwise OCT for treatment optimization in provisional approach of bifurcated coronary lesions

Left main bifurcation instent restenosis - LIVE case

18 Dec 2024 – From GulfPCR-GIM 2024

A 76-year-old male with a history of LM PCI (2-stent strategy), RCA PCI, reduced LV function (25%), diabetes, and CKD presented with worsening angina. Angiography revealed in-stent restenosis at the ostium of the LAD and CX, along with RCA occlusion.

The procedure was performed with axillary Impella...

Left main bifurcation instent restenosis  - LIVE case

Optical coherence tomography predictors of clinical outcomes after stent implantation: the ILUMIEN IV trial

04 Nov 2024

The aim of this pre-specified analysis of the ILUMIEN IV trial was to assess the relationship between post-PCI OCT parameters of suboptimal stent implantation and clinical outcomes.

Rick Volleberg

Reviewer

Rick Volleberg
Nicola Ryan

Reviewer

Nicola Ryan
Optical coherence tomography predictors of clinical outcomes after stent implantation: the ILUMIEN IV trial

Artificial intelligence-based fully automated quantitative coronary angiography versus optical coherence tomography guidance for coronary stent implantation: a multicenter, randomised controlled non-inferiority trial (FLASH)

07 Nov 2024

Panos Xaplanteris provides his take on the FLASH trial presented by Jung-Min Ahn at TCT 2024 in Washington.

Panagiotis Xaplanteris

Author

Panagiotis Xaplanteris
Artificial intelligence-based fully automated quantitative coronary angiography vs OCT guidance for coronary stent implantation: a multicenter, randomised controlled non-inferiority trial (FLASH)

A large-scale, randomized trial of orbital atherectomy vs. conventional balloon angioplasty in severely calcified coronary arteries prior to DES implantation (ECLIPSE)

30 Oct 2024

Nicola Ryan provides her take on the ECLIPSE trial presented by Ajay J. Kirtane at TCT 2024 in Washington.

Nicola Ryan

Author

Nicola Ryan
A large-scale, randomized trial of orbital atherectomy vs. conventional balloon angioplasty in severely calcified coronary arteries prior to DES implantation (ECLIPSE)

Contrast-induced acute kidney injury in patients undergoing PCI

08 Oct 2024

Coronary angiography and percutaneous coronary intervention (PCI) utilising intravascular iodinated contrast agents (ICA) are being widely performed in a growing number of elderly patients with multiple comorbidities.

Authors :

Antonio L. Bartorelli, Giancarlo Marenzi
The PCR Textbook - Contrast-induced acute kidney injury in patients undergoing PCI

Bifurcation PCI with TAP technique - LIVE case

05 Oct 2024 – From AICT-AsiaPCR 2024

A 72-year-old lady with dyslipidemia, hypertension and aspirin intolerance presented an NSTEMI. The coronary angiography showed a distal CX occlusion and a long calcified significant stenosis on proximal LAD with LAD/D3 bifurcation lesion, and a reduced LV function (47%).
Watch the operators as they perform an important...

Bifurcation PCI with TAP technique - LIVE case

Complex calcified left main bifurcation - LIVE case

05 Oct 2024 – From AICT-AsiaPCR 2024

An 82-year-old woman with diabetes, hypertension, a history of Micra and RCA PCI 2 years later, was admitted for NSTEMI. The coronary angiography showed a very calcified distal left main stenosis, a significant and calcified ostial LAD stenosis (medina: 1 1 0), confirmed by IVUS. She...

Complex calcified left main bifurcation  - LIVE case

Complex left main bifurcation PCI - LIVE case

05 Oct 2024 – From AICT-AsiaPCR 2024

Follow this case of a 65-year-old male with hypertension, a smoker with increasing angina. The coronary angiography found ostial calcified LAD and Circonflex confirmed by IVUS, with a preserved LV function.
The operators decided to perform a PCI of the distal left main with the DK-Crush technique...

Complex left main bifurcation PCI - LIVE case

Image-guided PCI of distal left main disease

05 Oct 2024 – From AICT-AsiaPCR 2024

Exploring a recorded case of image-guided PCI of distal left main disease, as well as a new paradigm in AI-driven imaging, and learn how coronary imaging aids in decision-making, optimises final outcomes, and enhances stent clarity to guide results in complex PCI procedures. Watch now to deepen...

Image-guided PCI of distal left main disease