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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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!

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

PCI of bifurcation lesions: management of complications - Part 3

17 May 2024 – From EuroPCR 2024

This session features additional selected EuroPCR 2024 clinical case submissions focusing on the management of complications during PCI of bifurcation lesions. Cases cover topics such as iatrogenic left main endarterectomy, left main dissections, and unexpected complications during various bifurcation stenting techniques. Discussions emphasize the importance of...

PCI of bifurcation lesions: management of complications - Part 3

PCI of bifurcation lesions: management of complications - Part 2

17 May 2024 – From EuroPCR 2024

This session features selected EuroPCR 2024 clinical case submissions showcasing the management of complications during PCI of bifurcation lesions. Cases cover topics such as navigating tricky ostial lesions, dealing with dissecting hematomas, undeflatable balloons, and distal left main perforations. Discussions focus on troubleshooting techniques and optimizing...

PCI of bifurcation lesions: management of complications - Part 2

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

Advancements in intracoronary imaging and intervention: unmasking vulnerable plaques and optimising durable PCI outcomes

16 May 2024 – From EuroPCR 2024

Delve into this EuroPCR 2024 session to gain insights into NIRS IVUS, exploring its applications, supported by current data, and understanding its clinical significance. Learn how to utilize NIRS IVUS in PCI planning through case examples, addressing lesion characteristics such as length and calcific nodules. Explore local...

Advancements in intracoronary imaging and intervention: unmasking vulnerable plaques and optimising durable PCI outcomes

Identification and treatment of (sub)clinical transcatheter valve thrombosis

16 May 2024 – From EuroPCR 2024

This session offers a practical guide to CT diagnosis of HALT/RLM, highlighting the importance of taking HALT/RLM seriously and providing insights into approaching HALT/HAM and the potential impact of pharmacotherapy. Gain knowledge on determining leaflet thickening and mobility through MSCT, receive updates on antithrombotic treatment strategies...

Identification and treatment of (sub)clinical transcatheter valve thrombosis

PCI of bifurcation lesions: management of complications - Part 1

16 May 2024 – From EuroPCR 2024

Explore strategies for managing complex PCI of bifurcation lesions through case discussions. From stent deformation and delicate diagonal wiring to wire fracture with snare failure, decoiled coronary guidewires, misplaced stents, spontaneous coronary artery dissection, and late tamponade after PCI, this session covers how to effectively respond...

Mastering Bifurcation PCI: Navigating the unexpected

Imaging-guided PCI for stent failure - LIVE case

16 May 2024 – From EuroPCR 2024

An 86-year-old male with PAD, a stroke in 2007, and a history of LAD PCI in 2006, presented with unstable angina due to LAD stent restenosis involving D1 and D2, with preserved LV function.
Guided by OCT, the operators performed stenosis preparation using IVL, treated the distal...

Imaging-guided PCI for stent failure - LIVE case