The Best of the SOLACI-SOCIME 2022 Main Arena: Complex PCI Guided by Intravascular Imaging

In the first session of SOLACI-SOCIME 2022 on “Complex angioplasty guided by intravascular imaging”, Dr. Alejandro Diaz (MEX) reviewed the evidence on intravascular ultrasound (IVUS) in complex angioplasties. A meta-analysis indicated its use is associated with a significant decrease in the risk of death, acute myocardial infarction (AMI), and new target lesion revascularization (TLR) in a period of 12 months to 4 years. 

He also emphasized the use of this tool for stent implantation in chronic total occlusions, which yields a low incidence of in-stent restenosis at follow-up, because stent expansion is optimized. 

However, in left main coronary artery disease (the Noble substudy), its use was associated with a lower rate of TLR. 

Dr. Diaz concluded his presentation with data from the ULTIMATE study, which showed a significant, 47-% reduction in the outcome “treated vessel failure” (TVF) compared with angiography (p = 0.019).

Afterwards, we were pleased to listen to Dr. Tomasz Mazurek (POL), who spoke about his experience in different scenarios, highlighting the importance of intravascular imaging in syndromes such as spontaneous coronary artery dissection when angiographic evidence is unclear or in cases of hemodynamic instability. He also emphasized the correct identification of thrombus in coronary syndromes by means of optical coherence tomography (OCT)—deemed the gold standard.

Dr. Omar Tupayachi

Dr. Omar Tupayachi.
Member of the editorial board of SOLACI.org.


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