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BackTable / Cardiology / Podcast / Episode #17
Update in Intravascular Imaging for Optimal PCI
with Dr. Erik Rafflenbeul
Intravascular imaging can provide invaluable intel on the coronaries, with OCT supplying bright ideas and IVUS giving sound judgement. Light-based and soundwave-based, respectively, mastery of these two imaging modalities can help you streamline routine PCI cases and overcome challenging ones. In this episode of BackTable Cardiology, the esteemed Dr. Erik Rafflenbeul from Schön Klinik in Hamburg, Germany joins host Dr. Hady Lichaa from Tennessee’s Ascension St. Thomas Heart to discuss intravascular imaging techniques for percutaneous coronary interventions.
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BackTable, LLC (Producer). (2025, December 16). Ep. 17 – Update in Intravascular Imaging for Optimal PCI [Audio podcast]. Retrieved from https://www.backtable.com
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Podcast Contributors
Synopsis
The conversation covers a wide range of topics, including the importance and benefits of using intravascular imaging, the differences and applications of intravascular ultrasound (IVUS) and optical coherence tomography (OCT) systems, recent intravascular clinical studies to know, and practical aspects of integrating these technologies into daily practice. Dr. Rafflenbeul emphasizes the value of proactive imaging and shares comprehensive insights for both seasoned and early-career interventional cardiologists.
Timestamps
00:00 - Introduction
03:52 - Current State of Intravascular Imaging in Germany and Europe
05:26 - Importance of Intravascular Imaging in PCI
09:08 - Challenges and Adoption of Intravascular Imaging
13:30 - IVUS vs. OCT: Which to Choose?
17:06 - Practical Insights on IVUS and OCT Systems
28:50 - Pre-Procedural Measurements and Techniques
30:36 - Choosing Stent Diameters
32:22 - Practical Aspects of Stenting
36:40 - Post-PCI Assessment and Algorithm
40:35 - Recent Intravascular Imaging Studies
43:07 - Case Studies and Practical Tips
47:16 - Advice for Early Career Interventionalists
51:54 - Concluding Thoughts and Wisdom
Resources
Dr. Hady Lichaa
https://healthcare.ascension.org/find-care/provider/1336267533/hady-lichaa
Dr. Erik Rafflenbeul
https://www.pcronline.com/Physicians/Erik-Rafflenbeul
European Association of Percutaneous Cardiovascular Interventions (EAPCI)
https://www.escardio.org/Sub-specialty-communities/European-Association-of-Percutaneous-Cardiovascular-Interventions-%28EAPCI%29#
Optimal Intravascular Ultrasound-Guided Percutaneous Coronary Intervention in Patients With Multivessel Disease
https://www.jacc.org/doi/10.1016/j.jacasi.2022.12.009#:~:text=The%20OPTIVUS%20(Optimal%20IntraVascular%20Ultrasound)%2DComplex%20PCI%20study,infarction%20*%20Stroke%20*%20Any%20coronary%20revascularization
Intravascular imaging-guided coronary drug-eluting stent implantation: an updated network meta-analysis
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)02454-6/abstract
Orbital Atherectomy vs. Conventional Balloon Angioplasty in Severely Calcified Coronary Arteries Prior to DES Implantation - ECLIPSE
https://www.acc.org/Latest-in-Cardiology/Clinical-Trials/2024/10/25/04/32/eclipse
A Revised Optical Coherence Tomography–Derived Calcium Score to Predict Stent Underexpansion in Severely Calcified Lesions
https://www.sciencedirect.com/science/article/abs/pii/S193687982401817X#:~:text=Lesions%20with%20severe%20calcium%20as,higher%20risk%20for%20stent%20underexpansion.
Intravascular Imaging vs Angiography Guidance for PCI of Severely Calcified Lesions: The ECLIPSE Trial
https://pubmed.ncbi.nlm.nih.gov/41093451/#:~:text=The%20primary%20clinical%20outcome%20was,tomographic%20guidance%20and%20IVUS%20guidance.
Assessment of Dual AntiPlatelet Therapy with Drug-Eluting Stents - ADAPT-DES
https://www.acc.org/latest-in-cardiology/clinical-trials/2012/10/25/11/12/adapt-des
The Materials available on BackTable are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.
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