Benefit of Intravascular Imaging for Left Main PCI

A substudy of a large randomized trial demonstrates less target-vessel failure with the use of intravascular imaging.

The multicenter, randomized RENOVATE-COMPLEX-PCI trial conducted in Korea demonstrated lower rates of target-vessel failure at 2 years after complex percutaneous coronary intervention (PCI) guided by imaging (either intravascular ultrasound [IVUS] or optical coherence tomography) compared with conventional angiography (NEJM JW Cardiol March 8 2023 and N Engl J Med 2023; 388:1668). In this prespecified substudy, investigators compared outcomes among 192 patients with unprotected left main (LM) lesions undergoing PCI with imaging guidance (n=138) or angiographic guidance (n=54).

In the imaging-guided PCI group, IVUS was the predominant method utilized (93%). About half of the patients had acute coronary syndrome, and half had distal LM bifurca…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)