What Is the Best Approach to Guide Percutaneous Coronary Intervention?

An updated meta-analysis demonstrates that both intravascular imaging and physiologic guidance are each superior to angiographic guidance alone.

Since its introduction, percutaneous coronary intervention (PCI) has been guided by coronary angiography. It is well recognized, however, that angiography alone cannot determine the functional significance of many coronary lesions and also fails to define pre- and post-PCI anatomic features (such as calcification, precise stent dimensions, and the presence of untreated dissections) that are important for PCI outcomes. Although both intravascular imaging via ultrasound or optical coherence tomography and functional guidance using wire-based physiology have been shown to improve clinical outcomes, the dominant approach in contemporary practice remains PCI based solely on angiographic guidance.

To compare these three different approaches to PCI…

Reviewing Author

David J. Cohen, MD, MSc

Disclosures

Consultant/Advisory BoardMedtronic; Edwards Lifesciences; Abbott Vascular; Boston Scientific; St. Francis Hospital

Speaker’s BureauBoston Scientific; ZOLL Medical

Grant/Research SupportEdwards Lifesciences; Abbott Vascular; Boston Scientific; Corvia Medical; National Heart, Lung, and Blood Institute; Phillips, Inc.; St. Paul’s Hospital; V-Wave, Inc; ZOLL Medical; CathWorks, ANCORA

Editorial BoardsJACC; American Heart Journal; EuroIntervention; JSCAI; Structural Heart Journal

Leadership Positions in Professional SocietiesSociety of Thoracic Surgeons/American College of Cardiology TVT Registry (Co-Chair, Risk Model Development Committee); Cardiovascular Research Foundation (Co-Director, TCT Annual Meeting; Co-Director, New York Valves Annual Meeting)