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Updated: Jan 7, 2026

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
Intravascular Imaging-Guided Percutaneous Coronary Intervention: Transforming Precision and Outcomes in Contemporary
Malik Alqawasmi1, James C Blankenship2
1Department of Internal Medicine, University of New Mexico, Albuquerque, NM 87131, USA.
Intravascular imaging (IVI) significantly improves percutaneous coronary intervention (PCI) outcomes by guiding stent placement. Imaging-guided PCI reduces adverse events and enhances long-term stent patency, especially in complex cases.
Area of Science:
- Interventional Cardiology
- Cardiovascular Imaging
Background:
- Percutaneous coronary intervention (PCI) faces challenges in complex coronary anatomy.
- Optimal stent deployment and long-term outcomes remain critical goals.
Purpose of the Study:
- To review the current evidence, applications, and future of intravascular imaging (IVI)-guided PCI.
- To highlight the role of IVI in optimizing coronary revascularization.
Main Methods:
- Review of large-scale randomized trials (ULTIMATE, ILUMIEN) and meta-analyses.
- Comparison of angiography-guided PCI versus imaging-guided PCI (IVUS, OCT, NIRS).
Main Results:
- Imaging-guided PCI enables precise lesion assessment, stent sizing, and detection of deployment issues.
- Trials show reduced major adverse cardiovascular events (MACE) and improved stent patency with IVI guidance.
- Benefits are particularly noted in left main, bifurcation, and calcified lesions.
Conclusions:
- IVI-guided PCI is a valuable tool for enhancing PCI precision and patient outcomes.
- Variable adoption necessitates addressing cost, complexity, and training.
- Future advances promise seamless integration of IVI into routine practice.
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