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Engaging intracoronary imaging (IC) techniques such as intravascular ultrasound or optical coherence tomography enables the precise description of vessel architecture. These imaging modalities have well-established roles in providing guidance and optimizing percutaneous coronary intervention (PCI) outcomes. Furthermore, IC is increasingly recognized for its diagnostic capabilities, as it has the unique capacity to reveal vessel wall characteristics that may not be apparent through angiography alone. This manuscript thoroughly reviews the contemporary landscape of IC in clinical practice. Focused on current methodologies, the review explores the utility and advancements in IC techniques. Emphasizing their role in clarifying coronary pathophysiology, guiding PCI, and optimizing patient outcomes, the manuscript critically evaluates the strengths and limitations of each modality. Additionally, the integration of IC into routine clinical workflows and its impact on decision-making processes are discussed. By synthesizing the latest evidence, this review provides valuable insights for clinicians, researchers, and healthcare professionals involved in the dynamic field of interventional cardiology.
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http://dx.doi.org/10.3390/jcm13144086 | DOI Listing |
Rev Cardiovasc Med
August 2025
Department of Cardiovascular Medicine, University Hospital Leuven, 3000 Leuven, Belgium.
Intravascular optical coherence tomography (OCT) has represented a revolutionary invasive imaging method, offering high-resolution cross-sectional views of human coronary arteries, thereby promoting a significant evolution in the understanding of vascular biology in both acute and chronic coronary pathologies. Since the development of OCT in the early 1990s, this technique has provided detailed insights into vascular biology, enabling a more thorough assessment of coronary artery disease (CAD) and the impact of percutaneous coronary intervention (PCI). Moreover, a series of recent clinical trials has consistently demonstrated the clinical benefits of intravascular imaging (IVI) and OCT-guided PCI, showing improved outcomes compared to angiography-guided procedures, particularly in cases of complex coronary pathology.
View Article and Find Full Text PDFRev Esp Cardiol (Engl Ed)
September 2025
Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, España; Servicio de Cardiología, Hospital Clínico de Santiago de Compostela, Santiago de Compostela, España.
Introduction And Objectives: This report presents the 2024 activity data from the Interventional Cardiology Association of the Spanish Society of Cardiology (ACI-SEC).
Methods: All interventional cardiology laboratories in Spain were invited to complete an online survey. Data analysis was conducted by an external company and then reviewed and presented by the ACI-SEC board.
Int J Cardiol
September 2025
Regional University Hospital Jean Minjoz, Besancon, France.
Background: The clinical benefit of using ICT for coronary stent optimization remains uncertain in randomized trials, in which a unique ICT was used in most cases.
Aim: To assess the clinical impact of intracoronary techniques (ICT) for stent optimization in high-risk patients.
Methods: The OPTI-XIENCE study is a prospective, observational, multicenter international study including high-risk patients undergoing coronary stenting, in whom any ICT was used for stent optimization at the operator's discretion.
Am J Cardiol
September 2025
School of Information, Kochi University of Technology, Kami 782-8502, Kochi, Japan. Electronic address:
Advances in intracoronary imaging have made it possible to distinguish different pathological mechanisms underlying acute coronary syndrome (ACS) in vivo. Accurate identification of these mechanisms is increasingly recognized as essential for enabling tailored therapeutic strategies. ACS pathogenesis is primarily classified into 2 major types: plaque rupture (PR) and plaque erosion (PE).
View Article and Find Full Text PDFCurr Opin Cardiol
August 2025
Division of Cardiology, University of California, San Francisco, San Francisco, California, USA.
Purpose Of Review: Complete revascularization (CR) by percutaneous coronary intervention (PCI) in acute coronary syndromes with multivessel coronary artery disease (CAD) was previously contraindicated in the absence of cardiogenic shock or high-risk ischemia. Over the last decade, CR has been a focus of recent clinical investigation and practice evolution due to high-quality evidence supporting hard cardiovascular outcome benefit, contributing to a reversal in international guidelines. This review provides concise syntheses of contemporary and emerging randomized evidence underpinning current strategies and unresolved questions regarding patient selection, timing of CR and guidance modalities for the identification and treatment of nonculprit lesions.
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