Imaging- vs Angiography-Guided PCI in Patients With Complex Anatomy

Background: Recent guidelines upgraded the use of intravascular ultrasound (IVUS) or optical coherence tomography (OCT) to a Class I recommendation to optimize results during percutaneous coronary intervention (PCI) for complex lesions. Sustained benefit beyond 2 years is uncertain. Objective: To evaluate the long-term clinical benefit of using intravascular imaging during PCI for complex coronary lesions. Design: Investigator-initiated, prospective, randomized, open-label multicenter RENOVATE-COMPLEX-PCI (Randomized Controlled Trial of Intravascular Imaging Guidance versus Angiography-Guidance on Clinical Outcomes After Complex Percutaneous Coronary Intervention) trial conducted in South Korea. Participants: Eligible patients were aged ≥19 years who were undergoing PCI for complex coronary lesions defined as: true bifurcation lesion with a side branch diameter ≥2.5 mm, chronic total occlusion, unprotected left main disease, long lesions (≥38 mm), ≥2 major epicardial vessels treated more...