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Updated: May 19, 2026
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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
Intracoronary Imaging for Percutaneous Coronary Intervention Guidance
Jaskanwal Deep S Sara1, Pedro E P Carvalho2, Arnold Seto3
1Center for Coronary Artery Disease, Minneapolis Heart Institute Foundation, Minneapolis, Minnesota; Allina Health Minneapolis Heart Institute, Abbott Northwestern Hospital, Minneapolis, Minnesota; Department of Cardiology, Minneapolis VA Medical Center, Minneapolis, Minnesota.
The American Journal of Cardiology
|May 17, 2026
Summary
Intracoronary imaging (ICI) improves outcomes during percutaneous coronary intervention (PCI) but remains underutilized. This review details ICI modalities, evidence, and practical guidance for its use in assessing coronary lesions and vulnerable plaque.
Area of Science:
- Cardiology
- Medical Imaging
- Interventional Cardiology
Background:
- Intracoronary imaging (ICI) is crucial for assessing coronary artery disease and guiding percutaneous coronary intervention (PCI).
- Despite strong evidence from trials and meta-analyses supporting ICI's benefits for clinical outcomes, its adoption in practice is limited.
- Guideline recommendations also advocate for ICI, yet utilization remains modest.
Purpose of the Study:
- To provide a comprehensive review of current intracoronary imaging modalities.
- To discuss clinical indications, advantages, limitations, and supporting evidence for ICI.
- To offer practical guidance on ICI use, procedural aspects, and identification of high-risk plaque features.
Main Methods:
- Review of extensive data, including randomized clinical trials and meta-analyses on ICI.
- Synthesis of information on contemporary ICI techniques and their applications.
- Analysis of procedural considerations and common challenges associated with ICI.
Main Results:
- ICI significantly aids in lesion morphology assessment and percutaneous coronary intervention guidance.
- A robust evidence base supports the use of ICI to enhance clinical outcomes.
- Identification of high-risk plaque features using ICI has important clinical implications.
Conclusions:
- Intracoronary imaging is an underutilized but vital tool in interventional cardiology.
- Further dissemination of practical guidance and addressing adoption barriers may increase ICI utilization.
- ICI enhances the understanding and management of complex coronary artery disease and vulnerable plaques.
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