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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ALL-RISE: A large-scale, global randomized trial of coronary physiology derived from conventional angiography compared with an invasive pressure wire-based approach to guide PCI

28 Mar 2026

Mirvat Al Asnag provides her take on the ALL-RISE randomised trial presented by Ajay J. Kirtane at ACC.26 in New Orleans.

Dr. Mirvat Alasnag

Author

Mirvat Alasnag
A large-scale, global randomized trial of coronary physiology derived from conventional angiography compared with an invasive pressure wire-based approach to guide percutaneous coronary intervention

Rapid CT-guided emergency TAVI-in-TAVI-in-valve for cardiogenic shock with high coronary obstruction risk

01 Apr 2026

An 85-year-old man presented in cardiogenic shock with torrential aortic regurgitation after prior surgical and TAVI valve-in-valve procedures. With high coronary obstruction risk, urgent CT assessment and in-silico simulations guided a rapid redo TAVI-in-TAVI-in-valve implantation, demonstrating that CT-assisted emergency redo-TAVI is feasible and lifesaving in high-risk...

Rapid CT-guided emergency TAVI-in-TAVI-in-valve for cardiogenic shock with high coronary obstruction risk

IVUS-guided versus angiography-guided PCI in unprotected left main coronary artery disease – The OPTIMAL trial

31 Mar 2026

Ali Nazmi Calik provides his take on the results of the OPTIMAL trial presented by Luca Testa at ACC.26 in New Orleans.

Author

Ali Nazmi Calik
Intravascular ultrasound-guided versus angiography-guided percutaneous coronary intervention in unprotected left main coronary artery disease – The OPTIMAL trial

Contemporary approach in the treatment of calcified coronary artery disease

28 Feb 2026 – From Euro4C Annual Meeting 2026

Adopt a contemporary approach to managing calcified coronary artery disease by leveraging high-definition IVUS for lesion assessment and morphology evaluation. Learn to tailor calcium modification strategies based on IVUS findings and combine available tools to optimize treatment outcomes according to patient and lesion profiles.

Contemporary approach in the treatment of calcified coronary artery disease

It is a calcified left main: do it well, do it safely

28 Feb 2026 – From Euro4C Annual Meeting 2026

This session addresses the complexities of percutaneous coronary intervention (PCI) in calcified left main coronary artery disease. It covers comprehensive planning including mechanical circulatory support, intravascular imaging, and bifurcation strategies. Attendees will also learn to anticipate and manage potential complications and apply various tools to ensure...

It is a calcified left main: do it well, do it safely

Imaging-guided intravascular lithotripsy for calcified lesions - LIVE case

27 Feb 2026 – From Euro4C Annual Meeting 2026

This live educational case from St. Francis Hospital and Heart Center demonstrates imaging-guided intravascular lithotripsy for calcified lesions. It covers lesion selection criteria, preparation and delivery of lithotripsy catheters, and reviews recent clinical evidence to guide best practices.

LIVE Educational Case from St. Francis Hospital & Heart...

Imaging-guided intravascular lithotripsy for calcified lesions - LIVE case

Ivus or angiography guidance for PCI in complex coronary bifurcation lesions (DKCRUSH-VIII)

31 Mar 2026

Nicola Ryan provides her take on DKCRUSH-VIII, a randomised controlled trial comparing IVUS versus angiography guidance for PCI, predominantly using the DKCRUSH technique in patients with complex bifurcation lesions, as presented by Shaoliang Chen at ACC.26 in New Orleans.

Nicola Ryan

Author

Nicola Ryan
DKCrush VIII: Ivus or angiography guidance for PCI in complex coronary bifurcation lesions

Intravascular ultrasound-guided or angiography-guided complex high-risk PCI – The IVUS CHIP trial

28 Mar 2026

Daniele Giacoppo reports and provides his perspective on the main results of the IVUS-CHIP trial, presented by Roberto Diletti from the Erasmus University Medical Center, Rotterdam, the Netherlands, during a Late-Breaking Trials session at the ACC.26 in New Orleans, and simultaneously published in the New England Journal of...

Daniele Giacoppo

Author

Daniele Giacoppo
Intravascular ultrasound guidance for complex high-risk indicated procedures – The Ivus Chip trial

FFR or 3d-quantitative coronary angiography-based vessel-FFR guided revascularisation – The FAST III trial

28 Mar 2026

Chiara De Biase provides her take on the FAST III Trial presented by Joost Daemen at ACC.26 in New Orleans. She reviews the comparison between vFFR and FFR, highlighting key findings and their impact on revascularisation strategies.

Author

Chiara De Biase
FAST III: FFR vs 3D-QCA vessel-guided revascularisation

Coronary OCT and CMR imaging to determine sex differences in underlying causes of myocardial infarction with no obstructive coronary arteries

29 Mar 2026

Nicola Ryan provides her take on the trial evaluating multi-modality imaging to determine underlying causes of MINOCA in women and men. The trial results were presented by Harmony R. Reynolds at ACC.26 in New Orleans and simultaneously published in Circulation.

Nicola Ryan

Author

Nicola Ryan
Coronary optical coherence tomography and cardiac magnetic resonance imaging to determine sex differences in underlying causes of myocardial infarction with no obstructive coronary arteries