IVUS-Guided Versus OCT-Guided Coronary Stent Implantation: A Critical Appraisal

Akiko Maehara, Mitsuaki Matsumura, Ziad A. Ali, Gary S. Mintz, Gregg W. Stone

Research output: Contribution to journalReview articlepeer-review

170 Scopus citations


Procedural guidance with intravascular ultrasound (IVUS) imaging improves the clinical outcomes of patients undergoing percutaneous coronary intervention (PCI) by: 1) informing the necessity for lesion preparation; 2) directing appropriate stent sizing to maximize the final stent area and minimize geographic miss; 3) selecting the optimal stent length to cover residual disease adjacent to the lesion, thus minimizing geographic miss; 4) guiding optimal stent expansion; 5) identifying acute complications (edge dissection, stent malapposition, tissue protrusion); and 6) clarifying the mechanism of late stent failure (stent thrombosis, neointimal hyperplasia, stent underexpansion or fracture, or neoatherosclerosis). Optical coherence tomography (OCT) provides similar information to IVUS (with some important differences), also potentially improving acute and long-term patient outcomes compared to angiography-guided PCI. The purpose of this review is to describe the similarities and differences between IVUS and OCT technologies, and to highlight the evidence supporting their utility to improve PCI outcomes.

Original languageEnglish
Pages (from-to)1487-1503
Number of pages17
JournalJACC: Cardiovascular Imaging
Issue number12
StatePublished - Dec 2017
Externally publishedYes


  • intravascular ultrasound
  • optical coherence tomography
  • percutaneous coronary intervention
  • stent(s)


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