Coronary disease & ACSRandomised controlled trial
Intravascular Ultrasound–Guided or Angiography-Guided Complex High-Risk percutaneous coronary intervention (PCI)
- Randomised controlled trial
- investigator-initiated
- international
- open-label
Authors' conclusion
Among patients undergoing complex high-risk PCI, a strategy of routine IVUS-guided PCI performed with the use of prespecified stent-optimization criteria was not associated with a lower risk of target-vessel failure than angiography-guided PCI alone.
Study context
- Population
- Patients undergoing complex high-risk PCI
- Participants
- 2,020 patients
- Comparison
- Intravascular ultrasound (IVUS)-guided PCI vs angiography-guided PCI
- IVUS-guided PCIn = 1,010
- Angiography-guided PCIn = 1,009reference
- Primary endpoint
- Target-vessel failure:
- Cardiac death
- Target-vessel MI
- Clinically indicated target-vessel revascularization
- Follow-up
- Median 19.0 months (IQR 15.2 to 23.4)
Primary result
Target-vessel failure · median 19.0 months
Hazard ratio
1.25
95% CI 0.97–1.60
P = 0.08
Events by treatment group
IVUS-guided PCI vs Angiography-guided PCI
HR 1.25 (95% CI 0.97–1.60); P = 0.08
As reported in the abstract
Further findings
Procedure duration
Post-stent balloon dilation
Safety
Procedural complications
Procedural complications
- Adverse events appeared similar in the two groups
Original publication
Intravascular Ultrasound–Guided or Angiography-Guided Complex High-Risk PCI. N Engl J Med. Published 30 March 2026. doi:10.1056/nejmoa2601521
Summarised from the published abstract; every number is checked against it