Vol. 3 No. 2 (2026): April - June
63-72
2026-06-29
Open Access

The role of intravascular imaging and physiological assessment in complex percutaneous coronary intervention: a systematic literature review

Bakhtiyorjon Yuldashov
Khurshid G.Fozilov
Bakhtiyor R.Atamuratov
https://doi.org/10.70626/cardiouz-2026-3-00088

Received: 2026-02-23

Published: 2026-06-29

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Abstract


This systematic literature review analyzes the diagnostic and clinical significance of intravascular imaging methods (IVUS, OCT) and physiological assessment techniques (FFR, iFR) in complex percutaneous coronary intervention (PCI).  Aim. To systematically evaluate the impact of intravascular imaging and physiological assessment methods on PCI outcomes in patients with complex coronary lesions. Materials and Methods. A total of 39 scientific sources published between 2009 and 2025 and indexed in PubMed, Scopus, Web of Science, and Google Scholar were analyzed. These included major randomized clinical trials such as RENOVATE-COMPLEX-PCI, ULTIMATE, ILUMIEN IV, FAME 1–3, DEFINE-FLAIR, and iFR-SWEDEHEART, as well as meta-analyses and international consensus documents. Results. PCI guided by intravascular imaging (IVUS or OCT) was found to reduce the 2-year rate of major adverse cardiovascular events (MACE) by 28% compared with conventional angiography (HR 0.72; 95% CI 0.62–0.85). FFR- and iFR-guided PCI strategies demonstrated equivalent outcomes. In complex PCI, the primary endpoint occurred in 7.7% of patients in the intravascular imaging group compared with 12.3% in the angiography group (HR 0.64; p=0.008). Conclusion. The use of intravascular imaging and physiological assessment methods in complex coronary lesions significantly improves clinical outcomes and is designated as a high-level recommendation in contemporary clinical guidelines.


 



 

Keywords

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About the Authors

Bakhtiyorjon Yuldashov
ybaxtiyorjon@gmail.com
Republican Specialized Scientific and Practical Medical Center of Cardiology
Khurshid G.Fozilov
hurshidfozilov1976@icloud.com
Republican Specialized Scientific and Practical Medical Center of Cardiology
Bakhtiyor R.Atamuratov
baxtiyor-cardio@mail.ru
Republican Specialized Scientific and Practical Medical Center of Cardiology

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How to Cite

The role of intravascular imaging and physiological assessment in complex percutaneous coronary intervention: a systematic literature review (B. Yuldashov, K. Fozilov, & B. Atamuratov, Trans.). (2026). CARDIOLOGY OF UZBEKISTAN, 3(2), 63-72. https://doi.org/10.70626/cardiouz-2026-3-00088
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