Safety and Effectiveness of Intracoronary Imaging-Guided Percutaneous Coronary Intervention (PCI) in Contemporary Practice: Insights From BMC2
Authors' conclusion
In real-world practice, ICI-guided PCI was associated with larger stent/balloon diameters and longer stents. While ICI use was associated with dissections and perforations, there was no significant increase in the rate of these complications despite significant increases in ICI use and stent/balloon sizes during the study period. Further research is needed to evaluate the association between ICI use and procedural complications.
Study context
- Population
- De novo PCIs performed at nonfederal Michigan hospitals between July 2019 and June 2022
- Exposure
- Intracoronary imaging (ICI)-guided PCI compared with angiography alone
- ICI-guided PCIn = 16,777
- Outcome
- ICI use
- Follow-up
- July 2019 to June 2022
Methodological detailsregistry analysis, 48 nonfederal Michigan hospitals, adjusted odds ratios
- Registry analysis
- 48 nonfederal Michigan hospitals
- Adjusted odds ratios
Main finding
As reported in the abstract
ICI used in PCI-treated lesions
16 777
22.5%
ICI use, July 2019
11.2%
ICI use, June 2022
32.1%
Observational data: associations, not effects.
Further findings
| Outcome | Average patient/procedural-adjusted treatment effect (mm) (95% CI) |
|---|---|
| Stent diameterLarger with ICI · persisted when controlling for the operator | +0.19 (+0.16 to +0.22) |
| Maximum balloon diameterLarger with ICI · persisted when controlling for the operator | +0.45 (+0.40 to +0.51) |
| Stent lengthLonger with ICI · persisted when controlling for the operator | +3.51 (+2.54 to +4.48) |
Trends over study period · July 2019 to June 2022
- Increased ICI use and larger stent/balloon sizes, P for trend
- P < 0.001
- Rate of dissection, P for trend (no concomitant increase)
- P = 0.78
- Rate of perforation, P for trend (no concomitant increase)
- P = 0.33
Safety
| Outcome | Adjusted odds ratio (95% CI) | |
|---|---|---|
| DissectionsHigher risk with ICI | 2.55 (2.05–3.16) | |
| PerforationsHigher risk with ICI | 2.25 (1.74–2.91) | |
| 0.20.5125Adjusted odds ratio (log scale) |
Original publication
Safety and Effectiveness of Intracoronary Imaging-Guided PCI in Contemporary Practice: Insights From BMC2. Circ Cardiovasc Interv. Published 19 August 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →