Coronary disease & ACSSecondary analysis
Intravascular Imaging vs Angiography Guidance for Percutaneous Coronary Intervention (PCI) of Severely Calcified Lesions
- Secondary analysis of the ECLIPSE randomised trial
- Intravascular imaging (IVI) at operator discretion
- Median follow-up 365 days (Q1-Q3: 365-365 days)
Authors' conclusion
IVI guidance during PCI of severely calcified lesions was associated with improved 1-year clinical outcomes compared with angiographic guidance alone, whether OA or BA was used for vessel preparation prior to drug-eluting stent placement.
Study context
- Population
- Patients undergoing PCI of severely calcified lesions, randomised to orbital atherectomy vs balloon angioplasty before drug-eluting stent
- Participants
- 2,005 patients
- Comparison
- IVI guidance vs angiographic guidance alone during PCI
- IVIn = 1,246
- Angiographic guidance alonen = 759reference
- Primary endpoint
- Target vessel failure (TVF)
- Follow-up
- 1 year
Primary result
TVF (Kaplan-Meier estimate)
Adjusted hazard ratio
0.74
95% CI 0.56–0.97
P = 0.03
By group
IVI vs Angiographic guidance alone
adjusted HR 0.74 (95% CI 0.56–0.97); P = 0.03
As reported in the abstract
Further findings
| Outcome | OCT | IVUS | adjusted HR (95% CI) | P value | |
|---|---|---|---|---|---|
| TVF, OCT vs IVUS guidance · 1 year | 7.7% | 12.2% | 0.78 (0.52–1.18) | P = 0.24 | |
| 0.512Adjusted hazard ratio (log scale) |
Target vessel failure (TVF), IVI effect by randomised orbital atherectomy (OA) vs balloon angioplasty (BA) (subgroup)
- Effect of IVI guidance consistent in OA and BA
- interaction P = 0.48
Original publication
Intravascular Imaging vs Angiography Guidance for PCI of Severely Calcified Lesions. JACC Cardiovasc Interv. Published 13 October 2025. doi:10.1016/j.jcin.2025.08.024
Summarised from the published abstract; every number is checked against it