Choosing a Method for Guiding PCI

This editorial compares the use of fractional flow reserve (FFR) and intravascular ultrasonography (IVUS) to guide percutaneous coronary intervention (PCI) for intermediate coronary stenosis. FFR assesses the ischemic potential of a stenosis, while IVUS aids in stent sizing and placement. A randomized trial involving 1682 patients in Korea and China found FFR guidance noninferior to IVUS guidance for PCI outcomes at 24 months (8.1% vs. 8.5% composite events). However, IVUS led to more frequent stent implantation (65.3% vs. 44.4%), suggesting less stringent criteria. The study supports using either tool alone but highlights the need for further research in diverse populations and higher-risk scenarios.

This editorial compares the use of fractional flow reserve (FFR) and intravascular ultrasonography (IVUS) to guide percutaneous coronary intervention (PCI) for intermediate coronary stenosis. FFR assesses the ischemic potential of a stenosis, while IVUS aids in stent sizing and placement. A randomized trial involving 1682 patients in Korea and China found FFR guidance noninferior to IVUS guidance for PCI outcomes at 24 months (8.1% vs. 8.5% composite events). However, IVUS led to more frequent stent implantation (65.3% vs. 44.4%), suggesting less stringent criteria. The study supports using either tool alone but highlights the need for further research in diverse populations and higher-risk scenarios.