Review examines intracoronary imaging for PCI guidance in complex coronary disease

A state-of-the-art review in the European Heart Journal synthesizes contemporary evidence on intracoronary imaging for assessing coronary atherosclerosis and guiding percutaneous coronary intervention (PCI). It focuses on intravascular ultrasound and optical coherence tomography, drawing on recent randomized trials and current guideline recommendations. These modalities provide high-resolution visualization to support lesion characterization, stent sizing, and procedural planning.

According to the abstract, multiple randomized controlled trials have demonstrated reductions in major adverse cardiac events with imaging-guided PCI, including cardiac death, myocardial infarction, and repeat revascularization. The review emphasizes complex settings: left main coronary artery disease, other complex bifurcation lesions, calcified lesions, long lesions, and higher-risk patients, including those with acute coronary syndrome.

The review also addresses imaging strengths, limitations, and unresolved research questions. However, the available abstract provides no trial sample sizes, effect estimates, or detailed guideline recommendations. Without the full text, the magnitude of benefit, differences between imaging modalities, and applicability to individual lesion subsets cannot be assessed from this source alone.