OCT noninferior to IVUS for guiding left main stenting, ESC 2026

Optical coherence tomography (OCT) was shown to be non‑inferior to intravascular ultrasound (IVUS) for guiding percutaneous coronary intervention in patients with left‑main coronary artery disease, according to data presented in a Hot Line session at the European Society of Cardiology (ESC) Congress 2026. The findings stem from a multicentre trial that compared the two intravascular imaging modalities in the context of stent implantation for this high‑risk lesion subset, using a pre‑specified non‑inferiority margin for the primary composite endpoint of major adverse cardiac events.

The study enrolled patients across several European sites and followed them for a median of 12 months after the procedure. Results indicated that rates of target‑lesion failure, myocardial infarction, and all‑cause mortality were comparable between the OCT‑guided and IVUS‑guided groups, meeting the statistical criteria for non‑inferiority. investigators highlighted that OCT’s higher spatial resolution and rapid image acquisition may offer procedural advantages without compromising clinical outcomes, suggesting that either imaging technique can be considered appropriate for left‑main stenting decisions.