Key result
Combining intracoronary imaging and physiology optimizes device selection and procedural outcomes in complex CAD.
Why the study?
Coronary imaging and physiology technologies have become cornerstones of contemporary PCI, necessitating a practical overview of their technical characteristics, advantages, limitations, and respective roles alongside recent trial evidence and guideline recommendations.
Answers are grounded in this paper and cite their sources.
This comprehensive review highlights how integrating intravascular imaging (IVUS, NIRS, OCT) and physiological assessment (FFR-CT, μFR) with angiography optimizes lesion assessment, procedural planning, and individualized treatment in contemporary PCI.
Coronary imaging technologies have become cornerstones of contemporary percutaneous coronary intervention (PCI), providing anatomical and physiological information that complements angiography and supports lesion assessment, procedural planning, device selection, procedural optimization and long-term risk stratification. This comprehensive review focuses on intravascular ultrasound (IVUS), near-infrared spectroscopy (NIRS), optical coherence tomography (OCT), fractional flow reserve computed tomography (FFR-CT), and the Murray law-based quantitative flow ratio (μFR), examining their current applications in modern PCI and providing a practical overview of their respective roles. These technologies are compared in terms of their technical characteristics, advantages and limitations in lesion assessment and PCI optimization. Evidence from recent major clinical trials and contemporary studies is critically reviewed alongside current guideline recommendations. The integration of anatomical, morphological and physiological information represents a key component of modern PCI, facilitating optimal device selection and procedural optimization while supporting individualized treatment strategies, particularly in patients with complex coronary artery disease (CAD).
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Paragliola et al. (2026) conducted a review in Coronary artery disease undergoing percutaneous coronary intervention. Intravascular imaging and physiological assessment (IVUS, NIRS, OCT, FFR-CT, μFR) vs. Conventional coronary angiography was evaluated. Integrating intravascular imaging (IVUS, NIRS, OCT) and physiology (FFR-CT, μFR) into modern PCI facilitates optimal device selection and procedural optimization in complex CAD.
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