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Modern PCI

See the vessel with HD IVUS

IVUS: The standard that guides Modern PCI​

Intravascular ultrasound (IVUS) delivers important vessel, disease, and stent details in just minutes. It’s now the standard of care for percutaneous coronary intervention (PCI), supported by compelling clinical evidence and listed in Guidelines from both ACC and ESC. ​

High-definition imaging inside the vessel generates actionable information, equipping interventional cardiologists to better apply their clinical expertise to optimize each unique procedure.

Strong evidence behind Class 1A Guideline from ACC

The latest ACC Guidelines recommend the use of intravascular ultrasound (IVUS) as a best practice for PCI in ACS patients with complex coronary lesions.1 By helping to optimize stent placement and ensure proper expansion, IVUS contributes to a significant reduction in complications, leading to better patient outcomes.2-5 The ACC Class 1A designation aligns with the Class 1A assigned in the 2024 ESC Guidelines,6 establishing a new standard in cardiovascular treatment. ​

Download the summary

The data is clear: patient outcomes improve with IVUS-guided PCI optimization. ​So why does IVUS adoption lag?​

A global consortium of physicians explored the question in a recent white paper, grouping the challenges in three primary categories:7​

Illustrated image of healthcare provider with thought bubble thinking.

Pillar One

Acceptability​

While ample clinical evidence exists, lack of familiarity with the supporting data and comfort with the status quo may prevent some interventional cardiologists from exploring IVUS. ​

Read a summary of barriers to Acceptability.​

Illustrated image of healthcare provider viewing screen with patient laying on exam table in rear.

Pillar Two

Acceptance

For interventional cardiologists who are considering IVUS, or have used it on a limited basis, uncertainty about onboarding and available training can create barriers to acceptance. 

Read a summary of barriers to Acceptance.

Illustrated image of healthcare provider pointing to data with second provider viewing laptop.

Pillar Three

Adoption

To enable adoption of IVUS, interventional cardiologists may need support to counter anticipated or actual resistance from administrators or catheterization laboratory staff. 

Read a summary of barriers to Adoption.

Overcoming barriers: Resources that support better PCI outcomes

Further fueled by the white paper discussed above, Boston Scientific continues to explore ways to support interventional cardiologists, administrators, and cath lab care teams in accessing the data and training needed to adopt IVUS for PCI procedures. These efforts span three strategic areas of focus.

Clinical evidence

We make connecting with the latest data – and sharing it with your hospital team – easy with links to essential videos and clinical data. 

Training & education

Our holistic approach to education and training includes opportunities for interventional cardiologists and the entire cath lab team. 

  • EDUCARE IVUS Series
  • IVUS + Physiology Pro App
  • Medical Education programs – Consult with your Boston Scientific rep for current opportunities
  • Conferences / tradeshows – You can find us at CRT, ACC, TCT and other industry events throughout the year

Workflow efficiencies

Through videos and other helpful resources, we demonstrate how to implement simple IVUS workflows for reliable, repeatable results.

The Heart Expert Series - IVUS insights

Delve into the world of complex PCI with insights from leading experts on the role of intravascular ultrasound.

Watch now
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PCI guidance products

AVVIGO™+ Multi-Modality Guidance System.

AVVIGO™+ Multi-Modality Guidance System

Next-generation PCI guidance system designed to provide high-quality imaging with AI-supported workflows.

Explore the AVVIGO+ System
OPTICROSS™ HD Imaging Catheters.

IVUS HD Imaging Catheters

Superior HD IVUS image quality for use during procedure planning, stent placement, and post- procedure.

Explore OPTICROSS™ HD Imaging Catheters
Explore Comet™ II Pressure Guidewire.

Physiology / FFR Pressure Guidewire

A reliable and highly deliverable Physiology wire with optimal workhorse performance to diagnose and treat.

Explore the COMET™ II Pressure Guidewire

Modern PCI: SEE. PREP. TREAT

As PCIs grow more complex, imaging is key to obtaining a clear view of the vessel of interest. Once you’ve assessed the extent of the plaque and determined the morphology, how can you choose the appropriate prep strategy?

Now PREP the Vessel

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  1. Rao SV, O’Donoghue ML, Ruel M, et al. 2025 ACC/AHA/ACEP/NAEMSP/SCAI guideline for the management of patients with acute coronary syndromes: A report of the American College of Cardiology/American Heart Association joint committee on clinical practice guidelines. Circulation. 2025;151.
  2. Lee, JM, Choi, KH, Lee, JY, et. Al. Intravascular Imaging-Guided or Angiography-Guided Complex PCI. N Engl J Med 2023; 388:1668-1679. doi:1056/NEJMoa2216607 
  3. Li X, Ge Z, Kan J, et al. Intravascular ultrasound-guided versus angiography-guided percutaneous coronary intervention in acute coronary syndromes (IVUS-ACS): a two-stage, multicentre, randomised trial. Lancet. 2024;403(10439):1855-1865. doi:10.1016/S0140-6736(24)00282-4
  4. Sung-Jin Hong, MD; Byeong-Keuk Kim, MD; Dong-Ho Shin, MD, MPH; et al. Effect of Intravascular Ultrasound–Guided vs Angiography-Guided Everolimus-Eluting Stent Implantation The IVUS-XPL Randomized Clinical Trial. JAMA. 2015;314(20):2155-2163. doi:10.1001/jama.2015.15454 
  5. Zhang J, Gao X, Kan J, et al. Intravascular Ultrasound Versus Angiography-Guided Drug-Eluting Stent Implantation: The ULTIMATE Trial. J Am Coll Cardiol Intv. 2018;72(24):3126-3137. doi: 10.1016/j.jacc.2018.09.013
  6. Vrints C, Andreotti F, Koskinas KC, et al, 2024 ESC guidelines for the management of chronic coronary syndromes. Eur Heart J. 2024;45:3415–3537.
  7. Escaned J, Lombardi M, Götberg M, et al. Factors contributing to low utilization of intracoronary imaging in clinical practice: A white paper. J Soc Cardiovasc Angiogr Interv. 2025;4:103607.