Intravascular Imaging During Percutaneous Coronary Intervention: JACC State-of-the-Art Review.

Coronary angiography has historically served as the gold standard for diagnosis of coronary artery disease and guidance of percutaneous coronary intervention (PCI). Adjunctive use of contemporary intravascular imaging (IVI) technologies has emerged as a complement to conventional angiography-to further characterize plaque morphology and optimize the performance of PCI. IVI has utility for preintervention lesion and vessel assessment, periprocedural guidance of lesion preparation and stent deployment, and postintervention assessment of optimal endpoints and exclusion of complications. The role of IVI in reducing major adverse cardiac events in complex lesion subsets is emerging, and further studies evaluating broader use are underway or in development. This paper provides an overview of currently available IVI technologies, reviews data supporting their utilization for PCI guidance and optimization across a variety of lesion subsets, proposes best practices, and advocates for broader use of these technologies as a part of contemporary practice.
Competing Interests: Funding Support and Author Disclosures Dr Truesdell has served as a consultant for/on the Speakers Bureau of Abiomed Inc and Shockwave Medical Inc. Dr Kaul has served as a consultant for Shockwave Medical Inc and Cardiovascular Systems Inc. Dr Riley has served as a consultant for Boston Scientific and Abbott Vascular. Dr Young has served as a consultant for/on the Advisory Board of Medtronic Inc. Dr Batchelor has served as a consultant for Boston Scientific, Abbott Vascular, Medtronic, Idorsia, and V Wave; and has received research grant support from Boston Scientific and Abbott Vascular. Dr Maehara has served as a consultant for Boston Scientific, Philips, and Shockwave Medical; and has served on the Advisory Board of SpectraWave. Dr Welt has served on the Advisory Board of Medtronic Inc; and has minor equity in Xenter Inc. Dr Kirtane has received institutional funding to Columbia University and/or Cardiovascular Research Foundation from Medtronic, Boston Scientific, Abbott Vascular, Amgen, Cardiovascular Systems Inc, Philips, ReCor Medical, Neurotronic, Biotronik, Chiesi, Bolt Medical, Magenta Medical, Canon, SoniVie, and Merck; in addition to research grants, institutional funding includes fees paid to Columbia University and/or Cardiovascular Research Foundation for consulting and/or speaking engagements in which Dr Kirtane controlled the content; has received consulting fees from IMDS; and has received travel expenses/meals from Medtronic, Boston Scientific, Abbott Vascular, Cardiovascular Systems Inc, Siemens, Philips, ReCor Medical, Chiesi, OpSens, Zoll, and Regeneron. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
(Copyright © 2023. Published by Elsevier Inc.)