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State of the art: role of intravascular imaging in the evolution of percutaneous coronary intervention – a 30-year review

1. Department of Cardiology, Barts Heart Centre, Barts Health NHS Trust, London, United Kingdom; 2. Institute of Cardiovascular Sciences, University College London, London, United Kingdom; 3. Department of Interventional Cardiology, Erasmus University Medical Center, Thoraxcenter, Rotterdam, the Netherlands; 4. The Heart Centre, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark; 5. Department of Interventional Cardiology, Bern University Hospital, Bern, Switzerland; 6. Faculty of Medicine, National Heart & Lung Institute, Imperial College London, London, United Kingdom

It has been 40 years since percutaneous coronary intervention (PCI) was introduced into the clinical setting. Over these years significant advances in device technology and the invention of new therapeutic strategies have broadened its applications in the clinical arena, rendering this treatment the first-line therapy for patients with obstructive coronary artery disease. The evolution of PCI would not have been possible without intravascular imaging which provided unique insights about coronary artery pathology, enabled evaluation of vessel wall response following PCI and allowed meticulous evaluation of the advantages and limitations of emerging devices. This review article appraises the role of intravascular imaging in the evolution of PCI, summarises the findings of invasive imaging studies that examined the efficacy of new therapies and endovascular devices, presents the evidence that supports its use in current clinical practice and discusses its future potential in PCI.

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