Abstract Background Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) are advanced imaging modalities that provide detailed vessel assessment and have shown potential to optimize peripheral arterial disease interventions. While angiography remains the standard for guidance during peripheral endovascular interventions, intravascular imaging offers superior visualization of lesion characteristics and vessel dimensions. This review aims to discuss the technology and principles of IVUS and OCT, evaluate their respective roles in peripheral endovascular interventions, and summarize clinical outcomes associated with their use. Methods A scoping review of the current literature was performed using MEDLINE and EMBASE databases from inception to September 21st, 2025 using keywords outlined in the manuscript. The conduct and reporting of this review followed established guidance for scoping reviews and adhered to PRISMA-ScR recommendations. Results Evidence regarding IVUS and OCT in peripheral endovascular interventions is heterogeneous. Compared to angiography alone, IVUS and OCT aid in planning adequate lesion preparation during peripheral endovascular interventions, improve stent implantation, reduce procedural complications, and demonstrate improved outcomes in terms of vessel patency and reintervention rates. OCT, with superior resolution, excels in assessing lesion morphology and identifying neointimal hyperplasia in in-stent restenosis. However, OCT is limited by reduced penetration depth, field of view, contrast usage, and the need for substantial blood clearance for optimal imaging. Conclusions IVUS and OCT offer benefits in the management of peripheral arterial disease. Their use facilitates precise vessel characterization and improves procedural outcomes. Further high-quality randomized studies are necessary to establish optimal indications and assess cost-effectiveness for these modalities.
Galo et al. (Tue,) studied this question.