Intravascular Ultrasound Imaging-Guided Percutaneous Coronary Intervention: Evidence and Practical Implications

Safi U. Khan; Neal S. Kleiman; Alpesh R. Shah

doi:10.14797/mdcvj.1611

Intravascular Ultrasound Imaging-Guided Percutaneous Coronary Intervention: Evidence and Practical Implications

Methodist DeBakey Cardiovascular Journal

Volume 21 (2025): Issue 4

By: Safi U. Khan , Neal S. Kleiman and Alpesh R. Shah

Open Access

|Oct 2025

Grüntzig A, Hopff H. [Percutaneous recanalization after chronic arterial occlusion with a new dilator-catheter (modification of the Dotter technique) (author’s transl)]. Dtsch Med Wochenschr. 1974 Dec 6;99(49):2502-10, 2511. doi: 10.1055/s-0028-1108161
Open DOI Search in Google Scholar Back to article
Martin DM, Boyle FJ. Drug-eluting stents for coronary artery disease: a review. Med Eng Phys. 2011 Mar;33(2):148-63. doi: 10.1016/j.medengphy.2010.10.009
Open DOI Search in Google Scholar Back to article
Yock PG, Linker DT, Angelsen BA. Two-dimensional intravascular ultrasound: technical development and initial clinical experience. J Am Soc Echocardiogr. 1989 Jul-Aug;2(4):296-304. doi: 10.1016/s0894-7317(89)80090-2
Open DOI Search in Google Scholar Back to article
Khan SU, Agarwal S, Arshad HB, et al. Intravascular imaging guided versus coronary angiography guided percutaneous coronary intervention: systematic review and meta-analysis. BMJ. 2023 Nov 16:383:e077848. doi: 10.1136/bmj-2023-077848
Open DOI Search in Google Scholar Back to article
Stone GW, Christiansen EH, Ali ZA, et al. Intravascular imaging-guided coronary drug-eluting stent implantation: an updated network meta-analysis. Lancet. 2024 Mar 2;403(10429):824-837. doi: 10.1016/S0140-6736(23)02454-6
Open DOI Search in Google Scholar Back to article
Vrints C, Andreotti F, Koskinas KC, et al. 2024 ESC Guidelines for the management of chronic coronary syndromes. Eur Heart J. 2024 Sep 29;45(36):3415-3537. doi: 10.1093/eurheartj/ehae177
Open DOI Search in Google Scholar Back to article
Rao SV, O’Donoghue ML, Ruel M, et al. 2025 ACC/AHA/ACEP/NAEMSP/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2025 Feb 27:S0735-1097(24)10424-X. doi: 10.1016/j.jacc.2024.11.009
Open DOI Search in Google Scholar Back to article
Xu J, Lo S. Fundamentals and role of intravascular ultrasound in percutaneous coronary intervention. Cardiovasc Diagn Ther. 2020 Oct;10(5):1358-1370. doi: 10.21037/cdt.2020.01.15
Open DOI Search in Google Scholar Back to article
Mintz GS. Intravascular imaging of coronary calcification and its clinical implications. JACC Cardiovasc Imaging. 2015 Apr;8(4):461-471. doi: 10.1016/j.jcmg.2015.02.003
Open DOI Search in Google Scholar Back to article
Mintz GS, Nissen SE, Anderson WD, et al. American College of Cardiology Clinical Expert Consensus Document on Standards for Acquisition, Measurement and Reporting of Intravascular Ultrasound Studies (IVUS). A report of the American College of Cardiology Task Force on Clinical Expert Consensus Documents. J Am Coll Cardiol. 2001 Apr;37(5):1478-92. doi: 10.1016/s0735-1097(01)01175-5
Open DOI Search in Google Scholar Back to article
Hong SJ, Mintz GS, Ahn CM, et al. Effect of Intravascular Ultrasound-Guided Drug-Eluting Stent Implantation: 5-Year Follow-Up of the IVUS-XPL Randomized Trial. JACC Cardiovasc Interv. 2020 Jan 13;13(1):62-71. doi: 10.1016/j.jcin.2019.09.033
Open DOI Search in Google Scholar Back to article
Zhang J, Gao X, Kan J, et al. Intravascular Ultrasound Versus Angiography-Guided Drug-Eluting Stent Implantation: The ULTIMATE Trial. J Am Coll Cardiol. 2018 Dec 18;72(24):3126-3137. doi: 10.1016/j.jacc.2018.09.013
Open DOI Search in Google Scholar Back to article
Giacoppo D, Laudani C, Occhipinti G, et al. Coronary Angiography, Intravascular Ultrasound, and Optical Coherence Tomography for Guiding of Percutaneous Coronary Intervention: A Systematic Review and Network Meta-Analysis. Circulation. 2024 Apr 2;149(14):1065-1086. doi: 10.1161/CIRCULATIONAHA.123.067583
Open DOI Search in Google Scholar Back to article
Fazel R, Yeh RW, Cohen DJ, et al. Intravascular imaging during percutaneous coronary intervention: temporal trends and clinical outcomes in the USA. Eur Heart J. 2023 Oct 12;44(38):3845-3855. doi: 10.1093/eurheartj/ehad430
Open DOI Search in Google Scholar Back to article
Kuno T, Miyamoto Y, Numasawa Y, et al. Enhancing Coronary Intervention Outcomes Using Intravascular Ultrasound: Analysis of Long-Term Benefits in a Japanese Multicenter Registry. J Soc Cardiovasc Angiogr Interv. 2023 Oct 24;3(1):101190. doi: 10.1016/j.jscai.2023.101190
Open DOI Search in Google Scholar Back to article
Park DW, Ahn JM, Yun SC, et al. 10-Year Outcomes of Stents Versus Coronary Artery Bypass Grafting for Left Main Coronary Artery Disease. J Am Coll Cardiol. 2018 Dec 11;72(23 Pt A):2813-2822. doi: 10.1016/j.jacc.2018.09.012
Open DOI Search in Google Scholar Back to article
Park SJ, Kim YH, Park DW, et al. Impact of intravascular ultrasound guidance on long-term mortality in stenting for unprotected left main coronary artery stenosis. Circ Cardiovasc Interv. 2009 Jun;2(3):167-77. doi: 10.1161/CIRCINTERVENTIONS.108.799494
Open DOI Search in Google Scholar Back to article
Kim JS, Hong MK, Ko YG, et al. Impact of intravascular ultrasound guidance on long-term clinical outcomes in patients treated with drug-eluting stent for bifurcation lesions: data from a Korean multicenter bifurcation registry. Am Heart J. 2011 Jan;161(1):180-7. doi: 10.1016/j.ahj.2010.10.002
Open DOI Search in Google Scholar Back to article
Kang SJ, Mintz GS, Kim WJ, et al. Preintervention angiographic and intravascular ultrasound predictors for side branch compromise after a single-stent crossover technique. Am J Cardiol. 2011 Jun 15;107(12):1787-93. doi: 10.1016/j.amjcard.2011.02.323
Open DOI Search in Google Scholar Back to article
Kim BK, Shin DH, Hong MK, et al. Clinical Impact of Intravascular Ultrasound-Guided Chronic Total Occlusion Intervention With Zotarolimus-Eluting Versus Biolimus-Eluting Stent Implantation: Randomized Study. Circ Cardiovasc Interv. 2015 Jul;8(7):e002592. doi: 10.1161/CIRCINTERVENTIONS.115.002592
Open DOI Search in Google Scholar Back to article
Ali ZA, Karimi Galougahi K, Nazif T, et al. Imaging- and physiology-guided percutaneous coronary intervention without contrast administration in advanced renal failure: a feasibility, safety, and outcome study. Eur Heart J. 2016 Oct 21;37(40):3090-3095. doi: 10.1093/eurheartj/ehw078
Open DOI Search in Google Scholar Back to article
Prasad M, Cassar A, Fetterly KA, et al. Co-registration of angiography and intravascular ultrasound images through image-based device tracking. Catheter Cardiovasc Interv. 2016 Dec;88(7):1077-1082. doi: 10.1002/ccd.26340
Open DOI Search in Google Scholar Back to article
Sacha J, Gierlotka M, Lipski P, Feusette P, Dudek D. Zero-contrast percutaneous coronary interventions to preserve kidney function in patients with severe renal impairment and hemodialysis subjects. Postepy Kardiol Interwencyjnej. 2019;15(2):137-142. doi: 10.5114/aic.2019.86008
Open DOI Search in Google Scholar Back to article
Bech GJ, De Bruyne B, Pijls NH, et al. Fractional flow reserve to determine the appropriateness of angioplasty in moderate coronary stenosis: a randomized trial. Circulation. 2001 Jun 19;103(24):2928-34. doi: 10.1161/01.cir.103.24.2928
Open DOI Search in Google Scholar Back to article
Tonino PA, De Bruyne B, Pijls NH, et al. Fractional flow reserve versus angiography for guiding percutaneous coronary intervention. N Engl J Med. 2009 Jan 15;360(3):213-24. doi: 10.1056/NEJMoa0807611
Open DOI Search in Google Scholar Back to article
De Bruyne B, Pijls NH, Kalesan B, et al. Fractional flow reserve-guided PCI versus medical therapy in stable coronary disease. N Engl J Med. 2012 Sep 13;367(11):991-1001. doi: 10.1056/NEJMoa1205361
Open DOI Search in Google Scholar Back to article
Mintz GS, Guagliumi G. Intravascular imaging in coronary artery disease. Lancet. 2017 Aug 19;390(10096):793-809. doi: 10.1016/S0140-6736(17)31957-8
Open DOI Search in Google Scholar Back to article
Koo BK, Hu X, Kang J, et al. Fractional Flow Reserve or Intravascular Ultrasonography to Guide PCI. N Engl J Med. 2022 Sep 1;387(9):779-789. doi: 10.1056/NEJMoa2201546
Open DOI Search in Google Scholar Back to article
Nicholls SJ, Hsu A, Wolski K, et al. Intravascular ultrasound-derived measures of coronary atherosclerotic plaque burden and clinical outcome. J Am Coll Cardiol. 2010 May 25;55(21):2399-407. doi: 10.1016/j.jacc.2010.02.026
Open DOI Search in Google Scholar Back to article
Schoenhagen P, Ziada KM, Kapadia SR, Crowe TD, Nissen SE, Tuzcu EM. Extent and direction of arterial remodeling in stable versus unstable coronary syndromes: an intravascular ultrasound study. Circulation. 2000 Feb 15;101(6):598-603. doi: 10.1161/01.cir.101.6.598
Open DOI Search in Google Scholar Back to article
Stone GW, Maehara A, Lansky AJ, et al. A prospective natural-history study of coronary atherosclerosis. N Engl J Med. 2011 Jan 20;364(3):226-35. doi: 10.1056/NEJMoa1002358
Open DOI Search in Google Scholar Back to article
Cheng JM, Garcia-Garcia HM, de Boer SP, et al. In vivo detection of high-risk coronary plaques by radiofrequency intravascular ultrasound and cardiovascular outcome: results of the ATHEROREMO-IVUS study. Eur Heart J. 2014 Mar;35(10):639-47. doi: 10.1093/eurheartj/eht484
Open DOI Search in Google Scholar Back to article
Park SJ, Ahn JM, Kang DY, et al. Preventive percutaneous coronary intervention versus optimal medical therapy alone for the treatment of vulnerable atherosclerotic coronary plaques (PREVENT): a multicentre, open-label, randomised controlled trial. Lancet. 2024 May 4;403(10438):1753-1765. doi: 10.1016/S0140-6736(24)00413-6
Open DOI Search in Google Scholar Back to article
Sakurai R, Ako J, Morino Y, et al. Predictors of edge stenosis following sirolimus-eluting stent deployment (a quantitative intravascular ultrasound analysis from the SIRIUS trial). Am J Cardiol. 2005 Nov 1;96(9):1251-3. doi: 10.1016/j.amjcard.2005.06.066
Open DOI Search in Google Scholar Back to article
Mintz GS, Painter JA, Pichard AD, et al. Atherosclerosis in angiographically “normal” coronary artery reference segments: an intravascular ultrasound study with clinical correlations. J Am Coll Cardiol. 1995 Jun;25(7):1479-85. doi: 10.1016/0735-1097(95)00088-l
Open DOI Search in Google Scholar Back to article
Mintz GS, Nissen SE, Anderson WD, et al. American College of Cardiology Clinical Expert Consensus Document on Standards for Acquisition, Measurement and Reporting of Intravascular Ultrasound Studies (IVUS). A report of the American College of Cardiology Task Force on Clinical Expert Consensus Documents. J Am Coll Cardiol. 2001 Apr;37(5):1478-92. doi: 10.1016/s0735-1097(01)01175-5
Open DOI Search in Google Scholar Back to article
Truesdell AG, Alasnag MA, Kaul P, et al. Intravascular Imaging During Percutaneous Coronary Intervention: JACC State-of-the-Art Review. J Am Coll Cardiol. 2023 Feb 14;81(6):590-605. doi: 10.1016/j.jacc.2022.11.045
Open DOI Search in Google Scholar Back to article
Prasad M, Cassar A, Fetterly KA, et al. Co-registration of angiography and intravascular ultrasound images through image-based device tracking. Catheter Cardiovasc Interv. 2016 Dec;88(7):1077-1082. doi: 10.1002/ccd.26340
Open DOI Search in Google Scholar Back to article
Uren NG, Schwarzacher SP, Metz JA, et al. Predictors and outcomes of stent thrombosis: an intravascular ultrasound registry. Eur Heart J. 2002 Jan;23(2):124-32. doi: 10.1053/euhj.2001.2707
Open DOI Search in Google Scholar Back to article
Okabe T, Mintz GS, Buch AN, et al. Intravascular ultrasound parameters associated with stent thrombosis after drug-eluting stent deployment. Am J Cardiol. 2007 Aug 15;100(4):615-20. doi: 10.1016/j.amjcard.2007.03.072
Open DOI Search in Google Scholar Back to article
de Jaegere P, Mudra H, Figulla H, et al. Intravascular ultrasound-guided optimized stent deployment. Immediate and 6 months clinical and angiographic results from the Multicenter Ultrasound Stenting in Coronaries Study (MUSIC Study). Eur Heart J. 1998 Aug;19(8):1214-23. doi: 10.1053/euhj.1998.1012
Open DOI Search in Google Scholar Back to article
Hong SJ, Kim BK, Shin DH, et al. Effect of Intravascular Ultrasound-Guided vs Angiography-Guided Everolimus-Eluting Stent Implantation: The IVUS-XPL Randomized Clinical Trial. JAMA. 2015 Nov 24;314(20):2155-63. doi: 10.1001/jama.2015.15454
Open DOI Search in Google Scholar Back to article
Räber L, Mintz GS, Koskinas KC, et al. Clinical use of intracoronary imaging. Part 1: guidance and optimization of coronary interventions. An expert consensus document of the European Association of Percutaneous Cardiovascular Interventions. Eur Heart J. 2018 Sep 14;39(35):3281-3300. doi: 10.1093/eurheartj/ehy285
Open DOI Search in Google Scholar Back to article
Kuno T, Kiyohara Y, Maehara A, et al. Comparison of Intravascular Imaging, Functional, or Angiographically Guided Coronary Intervention. J Am Coll Cardiol. 2023 Dec 5;82(23):2167-2176. doi: 10.1016/j.jacc.2023.09.823
Open DOI Search in Google Scholar Back to article
Lee JM, Choi KH, Song YB, et al. Intravascular Imaging-Guided or Angiography-Guided Complex PCI. N Engl J Med. 2023 May 4;388(18):1668-1679. doi: 10.1056/NEJMoa2216607
Open DOI Search in Google Scholar Back to article

Authors

Metrics

Articles in this issue

DOI: https://doi.org/10.14797/mdcvj.1611 | Journal eISSN: 1947-6108

Journal RSS Feed

Language: English

Page range: 26 - 36

Submitted on: Apr 7, 2025

Accepted on: May 27, 2025

Published on: Oct 1, 2025

Published by: Houston Methodist DeBakey Heart & Vascular Center

In partnership with: Paradigm Publishing Services

Keywords:

intravascular imaging,

IVUS,

percutaneous coronary intervention,

PCI

© 2025 Safi U. Khan, Neal S. Kleiman, Alpesh R. Shah, published by Houston Methodist DeBakey Heart & Vascular Center
This work is licensed under the Creative Commons Attribution-NonCommercial 4.0 License.

Volume 21 (2025): Issue 4