Coronary disease & ACS

Intravascular Ultrasound (IVUS) or Angiography Guidance for Percutaneous Coronary Intervention in Complex Coronary Bifurcation Lesions: The DKCRUSH VIII Randomized Clinical Trial

J Am Coll CardiolPublished Randomised controlled trial

Primary resultResult — go to the resultHazard ratio 0.40 95% CI 0.23–0.71

Authors' conclusion

In the present randomized trial comparing IVUS-guided vs angiography-guided PCI for complex coronary bifurcation lesions treated with the 2-stent DK crush technique, the benefits of IVUS-guided PCI at 1 year was achieved largely through achievement of IVUS-defined optimization targets rather than IVUS use alone.

Study context

Population
Patients with clinical indications for percutaneous coronary intervention (PCI) and a complex bifurcation lesion by DEFINITION criteria (particularly side branch lesion length ≥10 mm)
Participants
555 patients
Comparison
IVUS-guided PCI vs angiography-guided PCI
  • IVUS-guided PCIn = 277
  • Angiography-guided PCIn = 278reference
Primary endpoint
Target vessel failure:
  • Cardiac death
  • Target vessel MI
  • Clinically driven target vessel revascularization
Follow-up
1 year after randomization
Methodological detailsmulticentre, open-label, 24 centres in China
  • Multicentre
  • Open-label
  • 24 centres in China

Primary result

As reported in the abstract

1 year

Hazard ratio

0.40

95% CI 0.23–0.71

P = 0.002

Events by treatment group

IVUS-guided PCIvs Angiography-guided PCI
HR 0.40 (95% CI 0.23–0.71); P = 0.002

Original publication

IVUS or Angiography Guidance for Percutaneous Coronary Intervention in Complex Coronary Bifurcation Lesions: The DKCRUSH VIII Randomized Clinical Trial. J Am Coll Cardiol. Published 30 March 2026. doi:10.1016/j.jacc.2026.01.081

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