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 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

Cracking new horizons across all calcium morphologies

04 Oct 2024 – From AICT-AsiaPCR 2024

This session explores the challenges of treating calcified lesions during percutaneous coronary intervention (PCI). Learn how calcium can impede stent deliverability and expansion, potentially leading to thrombosis and restenosis. Discover the innovative Shockwave IVL technology, which uses sonic pressure waves to fracture calcium without harming surrounding...

Cracking new horizons across all calcium morphologies

Optimising outcomes in treating multivessel disease - LIVE case

04 Oct 2024 – From AICT-AsiaPCR 2024

A 75-year-old male with hypertension, dyslipidemia and a lot of co-morbidities presented a positive echo stress test. The coronary angiography showed diffuse calcified disease on LAD, CX, OM1 and RCA. There is significant stenosis on ostial RCA, mid LAD, mid CX and OM1.
After physiology assessment...

Optimising outcomes in treating multivessel disease - LIVE case

Effect of colchicine on coronary plaque stability in acute coronary syndrome as assessed by optical coherence tomography: the COLOCT randomized clinical trial

27 Aug 2024

The rationale for this study was to provide direct evidence of colchicine's effects on plaque stabilization, particularly by assessing changes in plaque characteristics using optical coherence tomography (OCT).

Giovanni Occhipinti

Reviewer

Giovanni Occhipinti

Reviewer

Salvatore Brugaletta
Effect of colchicine on coronary plaque stability in acute coronary syndrome as assessed by optical coherence tomography: the COLOCT randomized clinical trial

OCCUPI - Optical coherence tomography-guided coronary intervention in patients with complex lesions

03 Sep 2024

Alex Sticchi provides his take on the OCCUPI trial presented by Kim Byeong-Keuk at the ESC Congress 2024 in London.

Alessandro Sticchi

Author

Alessandro Sticchi
OCCUPI - OCT-guided coronary intervention in patients with complex lesions

ESC Practice Guidelines 2024: chronic coronary syndromes

30 Aug 2024

Julia Grapsa provides her take on the Chronic Coronary Syndromes (CCS) Guidelines which were presented by Felicita Andreotti and Christiaan Vrints at ESC Congress 2024 in London.

Julia Grapsa

Author

Julia Grapsa
ESC Guidelines: chronic coronary syndromes

Optimal minimal stent area and impact of stent underexpansion in left main up-front 2-stent strategy

10 Jul 2024

The present study aimed to revise the IVUS-derived segmental MSA criteria for optimal stent expansion in patients undergoing an up-front 2-stent strategy using the crush technique for LM bifurcation lesions to predict the 5-year clinical outcomes.

Reviewer

Salvatore Brugaletta
Optimal minimal stent area and impact of stent underexpansion in left main up-front 2-stent strategy

Left Main PCI with Intracoronary Imaging Guidance

28 Jun 2024

Explore left main PCI with intracoronary imaging guidance should be routine, discuss the evidence base for IVUS/OCT guidance, and much more!

Imaging-guided left main PCI - LIVE case

17 May 2024 – From EuroPCR 2024

A 53-year-old male with a history of advanced malignancy (lung adenoma) and mid LAD PCI last year, along with multiple risk factors (hypertension, dyslipidemia, diabetes, and smoking), presented with angina and a positive stress test and CT. The angiography and CT showed significant left main stenosis...

Imaging-guided left main PCI

Management of PCI complications - Part 2

17 May 2024 – From EuroPCR 2024

This session focuses on the management of various PCI complications, including iatrogenic dissection after diagnostic coronary angiography, sinus node artery occlusion, a stuck 6F guide in the axillary artery, and the retrieval of a broken balloon. The session features a series of case presentations and discussions,...

Mastering PCI Complications - Part 2