Current Use of Intracoronary Imaging in Interventional Practice

Dear colleague,

The European Association of Percutaneous Cardiovascular Interventions (EAPCI) is collecting insights regarding the use of Intracoronary Imaging in Interventional Practice.

Despite robust evidence supporting the benefits of intracoronary imaging (IVUS and OCT) in PCI, its adoption remains inconsistent due to regional, institutional, and operator-level variations.

Since the 2016 EAPCI-CVIT survey, new clinical trials and the latest ESC guidelines (Class I A recommendation) have reinforced its role, particularly in complex lesions.

This survey aims to reassess current practices, evaluate changes in utilization, and identify persisting barriers to broader adoption.

GDPR disclaimer

Your participation is anonymous.

We will not disclose your identity to any third party.

We comply with the European General Data Protection Regulation (GDPR) 2016/679. Any personal data processed in connection with this survey will be treated confidentially and only used by the ESC for the purposes of market research and not for promotion. Survey results will be kept for a maximum of 48 months for analysis and quality control purposes. We take all reasonable care to prevent any unauthorised access to your personal data. We respect your privacy and your right to access, modify, or remove your personal data. At any time, you can ask to know what personal data is being held. If you have any questions about data protection or require further information, please contact our data protection officer (DPO) at dpo@escardio.org.

You have the right to end your participation in this survey at any time.

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* 1. Please confirm that you have read the above and agree to participate in this survey.

Yes

General Questions

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* 2. Please define your age group:

<40

40-50

>50

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* 3. Please select the professional description that best describes you:

Interventional cardiologist with more than 10 years of experience

Interventional cardiologist with 5-10 years of experience

Interventional cardiologist with less than 5 years of experience

Non-interventional cardiologist

Cardiologist in training

Other

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* 4. Please indicate your region of work:

Europe

Central and North America

South America

Asia Pacific

Africa

Middle East

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* 5. Please indicate your country of work (Drop-down selection).

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* 6. Please describe your institution:

University hospital

Non-academic public hospital

Private institution

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* 7. How many PCIs were performed in your center in the last year?

Less than 400

Between 400 and 600

Between 601 and 800

Between 801 and 1,000

More than 1,000

Specific practices in Intracoronary imaging

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* 8. Is intracoronary imaging [IVUS, OCT, or NIRS] performed in your center?

Yes

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* 9. How many PCI procedures in your center are performed with intracoronary imaging annually (estimated percentage)?

<10% of total PCI cases

10-25% of total PCI cases

26-50% of total PCI cases

>50% of total PCI cases

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* 10. How many PCI in complex anatomy (e.g. left main stem, true bifurcations, CTO, and long lesions) in your center are performed with intracoronary imaging annually (estimated percentage)?

<10% of total PCI cases

10-25% of total PCI cases

26-50% of total PCI cases

>50% of total PCI cases

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* 11. Do you have personal experience with performing intracoronary imaging?

No, I have never used intracoronary imaging

Yes, but only in highly selected patients

Yes, in a minority of patients (<5%)

Yes, in a notable proportion of patients (5-15%)

Yes, in a substantial proportion of patients (>15%)

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* 12. In your opinion, what are the clinical indications for IVUS or OCT? (Select all that apply):

Facilitate diagnosis in complex cases (complex/ambiguous anatomy on angiography)

Guide decision-making and procedural planning (strategy planning)

Optimize procedural results of stenting

Assess the severity of intermediate left main lesions

Assess the severity of intermediate NON-left main lesions

Guide bifurcation lesion interventions

Guide interventions in chronic total occlusions (CTO)

Guide left main interventions

Identify mechanisms of stent failure (stent thrombosis or in-stent restenosis)

Diagnostic workflow of Myocardial Infarction with Non-Obstructive Coronary Disease (MINOCA)

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* 13. In light of the recent evidence and the latest ESC guidelines, how has your use of intracoronary imaging in PCI changed?

I have increased my use of intracoronary imaging.

I have decreased my use of intracoronary imaging.

My use of intracoronary imaging has not changed.

I do not know.

Perceptions and barriers

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* 14. Which intracoronary imaging modality (IVUS vs. OCT) do you consider superior for PCI guidance?

IVUS is superior

OCT is superior

They are of comparable value

It depends on specific anatomy and patient characteristics

There is no conclusive data

I do not know

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* 15. What are the potential barriers to the use of intracoronary imaging in clinical practice? (Select all that apply):

High cost

Regulatory or reimbursement issues

Risk of procedural complications

Lack of training in use and interpretation

Prolongation of procedure time

Absence of established clinical value

Other (please specify)

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* 16. In your opinion, what outcomes are monitored to assess the impact of intracoronary imaging? (Select all that apply):

Reduced target lesion failure (TLF)

Reduced target vessel revascularization (TVR)

Decreased major adverse cardiovascular events (MACE)

Improved procedural success rates

Lower long-term mortality rates

Other (please specify)

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* 17. In light of recent evidence, are you convinced that intracoronary imaging improves clinical outcomes compared to angiography-only guidance?

No, it improves procedural results but not long term outcomes

Yes, it has potential, but evidence is not definitive

Yes, evidence supports improvement in outcomes

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* 18. In your opinion, what is the role of intracoronary imaging in simple lesions?

Intracoronary imaging offers no significant benefit over angio-guided PCI.

Intracoronary imaging provides some additional information, but its impact on outcomes in simple lesions remains uncertain.

Intracoronary imaging delivers substantial additional diagnostic insights that can enhance outcomes.

Intracoronary imaging is essential for optimal decision-making even in simple lesions.

Other (please specify)

Future trends

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* 19. How do you foresee the future use of intracoronary imaging?

It will remain unchanged

It will slightly increase

It will greatly increase

It will slightly decrease

It will greatly decrease