Intravascular Imaging - A Breakthrough in the Treatment of Coronary Artery Lesions
Intravascular imaging is key to effective treatment of coronary artery disease. According to cardiologists, the lack of its use in complex cases is today's malpractice, so it is high time for wider use in clinical practice.
Intravascular imaging (IVI) is a modern technology that enables precise assessment of the interior of blood vessels and significantly increases the effectiveness of coronary angioplasty procedures. In the guidelines of the European Society of Cardiology (ESC) from 2024, this method received the highest, first class of recommendations in the treatment of patients with so-called complex atherosclerotic changes. Although it is available and reimbursed in Poland, it is still not used on a wide scale. Experts emphasize that its wider use can realistically reduce the number of complications, heart attacks , and even deaths.
– Thanks to intravascular imaging , we can precisely determine the type of atherosclerotic plaque and choose the appropriate treatment strategy – including the length and diameter of the stent. The method also allows us to assess the quality of its implantation and detect any complications of the procedure. All this translates into better prognosis for the patient. Today, the lack of use of IVI in the treatment of complex changes is a serious error in art – says Prof. Janusz Kochman , head of the Invasive Cardiology Laboratory, 1st Cardiology Clinic, Medical University of Warsaw.
As the professor points out, this technology is of particular importance in patients with massive calcifications, long stenoses or changes in bifurcations and the left coronary artery trunk – a group of patients that is growing year by year. Despite reimbursement, many doctors do not use this method routinely. The reason is often a lack of practical training in the interpretation of the obtained images. This is precisely what specialist workshops, such as IC You, organized with invasive cardiologists in mind, are for.
– During training, we work on real cases from clinical practice, teaching how to interpret images and avoid typical errors. Thanks to this, doctors gain the confidence and knowledge needed to use IVI effectively. This not only increases patient safety, but also improves the quality of therapeutic decisions. We want this technology to become a standard in every hemodynamic laboratory – adds Prof. Kochman.
The future of this field is connected with the use of artificial intelligence – algorithms already support image analysis, automatically recognizing calcifications and helping to choose the right size of stent. However, the biggest challenge remains the identification of so-called vulnerable plaques, i.e. unstable changes that can suddenly lead to a heart attack. As Prof. Kochman says – these are still time bombs – if we find a way to defuse them in advance, we will change the fate of many patients.
Updated: 04/06/2025 07:30
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