ESC 2023 — Dr Ziad Ali (DeMatteis St Francis, US) joins us to discuss the findings from the ILUMIEN IV clinical trial (NCT03507777).

ILUMIEN IV (Abbott Medical Devices) is a prospective, single-blind clinical trial aiming to compare optical coherence tomography (OCT) to an angiography-guided stent implantation strategy. The trial investigated which method achieved a larger post-percutaneous coronary intervention (PCI) lumen dimension, and improved cardiovascular outcomes in a group of patients with high-risk clinical characteristics and/or high-risk angiographic lesions. This patient group was selected as they were deemed most likely to benefit from OCT guidance.

2487 patients were enrolled in the trial, and were randomly allocated to receive either coronary PCI guided by OCT, or coronary PCI guided by angiography. Results suggest that OCT-guided PCI led to a larger minimum stent area, but did not reduce the rate of target vessel failure over two years when compared with angiography-guided PCI. OCT-guided PCI was also found to significantly reduce OCT-guided PCI. 
 

Questions:

1. What was the rationale behind this trial?
2. What was the patient cohort and study design?
3. What were the key findings?
4. What are your take-home messages?
5. What are the next steps?

Recorded on-site at ESC Congress 2023, Amsterdam. 

Editors: Mirjam Boros and Jordan Rance
Video Specialists: Dan Brent, Tom Green, Mike Knight, Oliver Miles