Two imaging techniques equally as effective to guide complex stenting
Optical coherence tomography was noninferior to intravascular ultrasound to guide stenting in patients with left main coronary artery disease, according to results presented in a Hot Line session today at ESC Congress 2026.
A study presented at ESC Congress 2026 has shown that optical coherence tomography (OCT) and intravascular ultrasound (IVUS) are equally effective in guiding complex stenting procedures for patients with left main coronary artery disease. In the randomized ISOLEDS trial, 664 patients with true distal left main bifurcation lesions were equally divided between OCT and IVUS guidance.
After a median follow-up of 362 days, the 12-month target lesion failure rate was found to be noninferior in the OCT-guided group (14.4%) compared to the IVUS-guided group (19.6%). While OCT-guided stenting is considered an alternative option when anatomical, image acquisition, and expertise factors permit, the study does not establish equivalence or superiority between the two imaging techniques.
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