{"id":"16e817f232dc","type":"article","url":"https://hartvaat.nl/2023/05/04/renovate-complex-pci-intravasculaire-beeldvorming-versus-angiografie-bij-complex/","title":"RENOVATE-COMPLEX-PCI: intravasculaire beeldvorming versus angiografie bij complexe PCI","title_en":"Intravascular Imaging-Guided or Angiography-Guided Complex PCI.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":["intracoronaire-beeldvorming"],"journal":"The New England journal of medicine","doi":"10.1056/NEJMoa2216607","source_url":"https://doi.org/10.1056/NEJMoa2216607","authors":["Joo Myung Lee","Ki Hong Choi","Young Bin Song","Jong-Young Lee","Seung-Jae Lee","Sang Yeub Lee","Sang Min Kim","Kyeong Ho Yun","Jae Young Cho","Chan Joon Kim","Hyo-Suk Ahn","Chang-Wook Nam","Hyuck-Jun Yoon","Yong Hwan Park","Wang Soo Lee","Jin-Ok Jeong","Pil Sang Song","Joon-Hyung Doh","Sang-Ho Jo","Chang-Hwan Yoon","Min Gyu Kang","Jin-Sin Koh","Kwan Yong Lee","Young-Hyo Lim","Yun-Hyeong Cho","Jin-Man Cho","Woo Jin Jang","Kook-Jin Chun","David Hong","Taek Kyu Park","Jeong Hoon Yang","Seung-Hyuk Choi","Hyeon-Cheol Gwon","Joo-Yong Hahn"],"significance":9,"published":"2023-05-04","source_date":"2023-05-04","image":"","kennis":["https://hartvaat.nl/kennis/diagnostiek/intravasculaire-echografie-ivus-oct/","https://hartvaat.nl/kennis/coronairlijden/coronaire-angiografie-hartkatheterisatie/"],"congress":"","summary_en":"The RENOVATE-COMPLEX-PCI trial showed that intravascular imaging-guided PCI (using IVUS or OCT) significantly reduced the composite of cardiac death, MI, or revascularization compared with angiography-guided PCI in patients with complex coronary lesions. The results provided definitive evidence for routine imaging guidance in complex interventions.","created":"2026-07-03T10:30:21Z","updated":"2026-07-03T13:29:25Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"De RENOVATE-COMPLEX-PCI-trial in de NEJM toonde dat intravasculaire beeldvorming (IVUS of OCT)-geleide PCI bij complexe laesies superieur was aan angiografie-geleide PCI, met 36% minder cardiac death, MI en revascularisatie. Dit positioneert beeldvorming als standaard bij complexe PCI.","abstract_original":"BACKGROUND: Data regarding clinical outcomes after intravascular imaging-guided percutaneous coronary intervention (PCI) for complex coronary-artery lesions, as compared with outcomes after angiography-guided PCI, are limited. METHODS: In this prospective, multicenter, open-label trial in South Korea, we randomly assigned patients with complex coronary-artery lesions in a 2:1 ratio to undergo either intravascular imaging-guided PCI or angiography-guided PCI. In the intravascular imaging group, the choice between intravascular ultrasonography and optical coherence tomography was at the operators' discretion. The primary end point was a composite of death from cardiac causes, target-vessel-related myocardial infarction, or clinically driven target-vessel revascularization. Safety was also assessed. RESULTS: A total of 1639 patients underwent randomization, with 1092 assigned to undergo intravascular imaging-guided PCI and 547 assigned to undergo angiography-guided PCI. At a median follow-up of 2.1 years (interquartile range, 1.4 to 3.0), a primary end-point event had occurred in 76 patients (cumulative incidence, 7.7%) in the intravascular imaging group and in 60 patients (cumulative incidence, 12.3%) in the angiography group (hazard ratio, 0.64; 95% confidence interval, 0.45 to 0.89; P = 0.008). Death from cardiac causes occurred in 16 patients (cumulative incidence, 1.7%) in the intravascular imaging group and in 17 patients (cumulative incidence, 3.8%) in the angiography group; target-vessel-related myocardial infarction occurred in 38 (cumulative incidence, 3.7%) and 30 (cumulative incidence, 5.6%), respectively; and clinically driven target-vessel revascularization in 32 (cumulative incidence, 3.4%) and 25 (cumulative incidence, 5.5%), respectively. There were no apparent between-group differences in the incidence of procedure-related safety events. CONCLUSIONS: Among patients with complex coronary-artery lesions, intravascular imaging-guided PCI led to a lower risk of a composite of death from cardiac causes, target-vessel-related myocardial infarction, or clinically driven target-vessel revascularization than angiography-guided PCI. (Supported by Abbott Vascular and Boston Scientific; RENOVATE-COMPLEX-PCI ClinicalTrials.gov number, NCT03381872)."}