# RENOVATE-COMPLEX-PCI: intravasculaire beeldvorming versus angiografie bij complexe PCI

*geplaatst 2023-05-04 · Algemeen · The New England journal of medicine · doi 10.1056/NEJMoa2216607 · https://hartvaat.nl/2023/05/04/renovate-complex-pci-intravasculaire-beeldvorming-versus-angiografie-bij-complex/*

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.

## English: Intravascular Imaging-Guided or Angiography-Guided Complex PCI.

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.

## Abstract (original, from the publication)

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).

Auteurs: 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

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Bron: The New England journal of medicine, https://doi.org/10.1056/NEJMoa2216607. Bijgewerkt 2026-07-03T13:29:25Z. 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.