Episode # 17 • 16 Dec 2025
Update in Intravascular Imaging for Optimal PCI
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.
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
- Dr. Erik Rafflenbeul
- European Association of Percutaneous Cardiovascular Interventions (EAPCI)
- Optimal Intravascular Ultrasound-Guided Percutaneous Coronary Intervention in Patients With Multivessel Disease
- Intravascular imaging-guided coronary drug-eluting stent implantation: an updated network meta-analysis
- Orbital Atherectomy vs. Conventional Balloon Angioplasty in Severely Calcified Coronary Arteries Prior to DES Implantation - ECLIPSE
- A Revised Optical Coherence Tomography–Derived Calcium Score to Predict Stent Underexpansion in Severely Calcified Lesions
- Intravascular Imaging vs Angiography Guidance for PCI of Severely Calcified Lesions: The ECLIPSE Trial
- Assessment of Dual AntiPlatelet Therapy with Drug-Eluting Stents - ADAPT-DES
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More about this episode
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.
The Materials available on BackTable are provided for informational and educational purposes only and are not a substitute for the independent professional judgment of a qualified healthcare professional in diagnosing or treating patients. Any opinions, statements, or views expressed are those of the individual contributors and do not necessarily reflect those of the publisher, platform, or any affiliated organization.