The 2024 ESC Guidelines have upgraded the recommendation for intravascular ultrasound (IVUS) or optical coherence tomography (OCT) guidance during percutaneous coronary intervention (PCI) for anatomically complex lesions—specifically, Left Main, true bifurcations, and long lesions—to Class 1, Level A1.
This change is backed by recent clinical studies, including RENOVATE-Complex PCI (focused on complex lesions), IVUS-XPL (related to long lesions), and OCTOBER (addressing true bifurcations), all of which demonstrate that intravascular imaging significantly enhances patient outcomes compared to angiography alone.
An infographic summarizing the key data on IVUS is available for download.
IVUS Guidance Optimizes Coronary Outcomes
Intravascular ultrasound (IVUS) is a core tenet of the SYNTAX II 5 methodology for state-of-the-art PCI. The study’s five-year outcomes, along with several other highly-regarded trials, demonstrate that IVUS visualization optimizes long-term outcomes by enabling more comprehensive procedure planning, execution, and assessment.
