Calcified Artery Disease: IVUS & Stenting Outcomes
- Using intravascular imaging (IVI) to guide stent implantation proves safer and more effective than standard angiography for patients undergoing complex stenting procedures, notably those with severely calcified coronary...
- The ECLIPSE trial, presented at the american College of Cardiology Scientific Session in Chicago, compared IVI to angiography during percutaneous coronary intervention (PCI).
- Stone, Director of Academic Affairs for the Mount Sinai Health System and the study chair, said the ECLIPSE trial demonstrates that IVI guidance during coronary stenting in severely...
Intravascular imaging (IVI) dramatically improves outcomes in complex stent procedures, especially for those with calcified artery disease, according to the ECLIPSE trial. the study found IVI, encompassing IVUS and OCT, to be safer and more effective than standard angiography, considerably reducing death rates and the need for repeat procedures. This revolutionary approach, presented at the American College of Cardiology Scientific Session, may redefine treatment for high-risk patients. PCI, or percutaneous coronary intervention, which uses catheters and stents, is often complicated by calcified lesions.IVI provides detailed images, allowing for improved measurement and assessment. The ECLIPSE trial’s findings, which included 2,005 patients, saw 26% higher target vessel failure rates in angiography-guided procedures compared to IVI-guided ones. News Directory 3 offers insights on this and related topics. Curious about the potential for OCT versus IVUS in the future? Discover what’s next.
Intravascular Imaging Improves Outcomes in Stent Procedures
Updated March 31, 2025
Using intravascular imaging (IVI) to guide stent implantation proves safer and more effective than standard angiography for patients undergoing complex stenting procedures, notably those with severely calcified coronary artery disease, according to a new study.
The ECLIPSE trial, presented at the american College of Cardiology Scientific Session in Chicago, compared IVI to angiography during percutaneous coronary intervention (PCI). The findings suggest a potential shift in treatment for high-risk patients.
Dr. Gregg W. Stone, Director of Academic Affairs for the Mount Sinai Health System and the study chair, said the ECLIPSE trial demonstrates that IVI guidance during coronary stenting in severely calcified lesions prevents death, stent thrombosis, and the need for unplanned repeat procedures.He noted that current IVI usage is low in the United States, but expects it to increase rapidly as more studies show it’s benefits.
PCI involves using a catheter to place stents in blocked coronary arteries, restoring blood flow. About a third of these cases involve moderate or severely calcified lesions,making the procedure more challenging. Angiography, which uses dye and X-rays, is commonly used to guide the catheter, but it has limitations in determining artery size and plaque composition.
IVI, including intravascular ultrasound (IVUS) and optical coherence tomography (OCT), provides detailed two- and three-dimensional images of the arteries, offering a more accurate assessment than angiography alone. These techniques allow for better measurement of vessel dimensions and improved evaluation of stent implantation.
The ECLIPSE study analyzed PCI outcomes in 2,005 patients with severely calcified lesions. Patients were divided into two groups: one receiving PCI with IVI guidance (OCT or IVUS) and the other with angiography guidance. The primary endpoint was the one-year rate of target vessel failure, a composite of cardiac death, target-vessel myocardial infarction, or ischemia-driven target-vessel revascularization.
The study found that target vessel failure rates were 26% lower in the IVI-guided group compared to the angiography group. Researchers also observed a significant reduction in all-cause death, stent thrombosis, and target lesion and vessel revascularization with intravascular imaging.
Further analysis of IVUS and OCT showed that while OCT initially appeared to have better outcomes, the difference was not significant after adjusting for factors like age and diabetes.
Stone said that both OCT and IVUS were effective, and further studies are needed to determine if OCT is more beneficial in severely calcified lesions. He emphasized that IVI with either OCT or IVUS should be used instead of angiography to guide PCI in patients with severely calcified lesions.
“The ECLIPSE trial shows that use of IVI to guide coronary stenting in severely calcified lesions prevents death, stent thrombosis, and unplanned repeat procedures in this high-risk patient population.”
What’s next
Additional research is planned to determine the specific benefits of OCT versus IVUS in treating severely calcified lesions, perhaps refining future treatment protocols.