articleNew England Journal of MedicineMar 30, 2026Closed access

IVUS-Guided versus Angiography-Guided PCI in Unprotected Left Main Coronary Disease

Vita-Salute San Raffaele University · IRCCS Policlinico San Donato · +28 more institutions

PubMed
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Abstract

Background

Percutaneous coronary intervention (PCI) is increasingly used for revascularization of unprotected left main coronary artery disease. Whether intravascular ultrasonographic (IVUS) guidance during PCI results in better clinical outcomes than conventional angiographic guidance alone is uncertain.

Methods

In an international, multicenter, open-label trial, we randomly assigned patients with unprotected left main coronary artery disease in a 1:1 ratio to undergo either IVUS-guided PCI or angiography-guided PCI. The primary end point was a patient-oriented composite of any stroke, any myocardial infarction, any revascularization, or death from any cause at the longest follow-up.

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Funding