During percutaneous coronary intervention (PCI), guidance with optical coherence tomography (OCT) is non-inferior to intravascular ultrasound (IVUS) at 1 year post-procedure, a new study shows. Duk-Woo Park, MD, PhD, of the University of Ulsan College of Medicine, Seoul, South Korea, presented these results Sunday at the European Society of Cardiology (ESC) congress 2023 in Amsterdam. The trial was supported by grants from Abbott Vascular, Medtronic, and the CardioVascular Research Foundation of Seoul. Both OCT and IVUS are recommended for use for stent optimization in certain patients. Left main lesions are typically treated using IVUS guidance. The purpose of this trial was to examine the clinical efficacy and safety of OCT- and IVUS-guided strategies in patients undergoing PCI for diverse coronary-artery lesions. The Optical Coherence Tomography-guided versus IntraVascular UltraSound-guided percutaneous coronary intervention (OCTIVUS) trial randomized 1,000 patients to OCT-guided PCI and 1,000 patients to IVUS-guided PCI. The primary endpoint of this study was cardiac death, target-vessel myocardial infarction or ischemia-driven target vessel revascularization at 1 year. The primary endpoint was observed in 2.5% of the OCT-guided group and 3.1% of the IVUS-guided group at 12-months post-revascularization (hazard ratio [HR]=0.80, 95% confidence interval [CI]=0.47-1.36, p-noninferiority<0.001). Overall, OCT-guided PCI was noninferior to IVUS-guided PCI when primary endpoint outcomes were compared at 1 year. Most PCI procedures can safely utilize either method, with both producing similar short- and long-term outcomes, Park said. “There is very practical application [of the devices]…if you have some expertise of IVUS or OCT, you can choose any one,” he said. Image Caption: Duk-Woo Park, MD, PhD, speaks during a press conference at the European Society of Cardiology congress 2023 in Amsterdam. (Screenshot)