Optical Coherence Tomography–guided versus IntraVascular UltraSound–guided percutaneous coronary intervention - OCTIVUS

Contribution To Literature:

The OCTIVUS trial showed that OCT-guided PCI is noninferior to IVUS-guided PCI.


The goal of the trial was to evaluate optical coherence tomography (OCT)-guided percutaneous coronary intervention (PCI) compared with intravascular ultrasound (IVUS)-guided PCI among patients undergoing coronary revascularization.

Study Design

  • Randomized
  • Parallel

Patients undergoing coronary revascularization were randomized to OCT-guided PCI (n = 1,005) vs. IVUS-guided PCI (n = 1,003).

  • Total number of enrollees: 2,008
  • Duration of follow-up: 1 year
  • Mean patient age: 64 years
  • Percentage female: 21%
  • Percentage with diabetes: 32%

Inclusion criteria:

  • Patients ≥19 years of age undergoing PCI

Exclusion criteria:

  • ST-segment elevation myocardial infarction
  • Renal dysfunction
  • Cardiogenic shock or decompensated heart failure
  • Limited life expectancy

Other salient features/characteristics:

  • Diffuse long lesion, 57%
  • Total stent length, 47 mm

Principal Findings:

The primary outcome, cardiovascular death, target vessel myocardial infarction, or ischemia-driven target vessel revascularization, occurred in 2.5% of the OCT group vs. 3.1% of the IVUS group (p for noninferiority < 0.001).

Secondary outcomes:

  • Target vessel myocardial infarction: 0.9% of the OCT group vs. 1.4% of the IVUS group
  • Repeat revascularization: 1.6% of the OCT group vs. 1.9% of the IVUS group


Among patients undergoing coronary revascularization, OCT-guided PCI was noninferior to IVUS-guided PCI. Intravascular imaging is a useful tool to optimize stent implantation. The results of this study found that OCT resulted in similar outcomes compared with IVUS.


Kang DY, Ahn JM, Yun SC, et al., on behalf of the OCTIVUS Investigators. Optical Coherence Tomography-Guided or Intravascular Ultrasound Guided Percutaneous Coronary Intervention: The OCTIVUS Randomized Clinical Trial. Circulation 2023;Aug 27:[Epub ahead of print].

Presented by Dr. Duk-Woo Park at the European Society of Cardiology Congress, Amsterdam, Netherlands, August 27, 2023.

Clinical Topics: Cardiac Surgery, Invasive Cardiovascular Angiography and Intervention, Noninvasive Imaging, Atherosclerotic Disease (CAD/PAD), Aortic Surgery, Interventions and Coronary Artery Disease, Interventions and Imaging, Angiography, Echocardiography/Ultrasound, Nuclear Imaging

Keywords: Computed Tomography, Coronary Angiography, Coronary Artery Disease, Diagnostic Imaging, ESC Congress, ESC23, Myocardial Infarction, Myocardial Revascularization, Percutaneous Coronary Intervention, Stents, Tomography, Optical Coherence, Ultrasonography

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