Trial reportEuropean heart journal2025
Optical coherence tomography- vs angiography-guided coronary stent implantation in calcified lesions: the ILUMIEN IV trial.
Trial report in European heart journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
8 citing papers in PubMed.
- Efficacy and safety of the SoniCracker intravascular lithotripsy device for severely calcified coronary lesions: the LEAD-FIM study from China.BMC cardiovascular disorders · 2025Trial
- Intravascular ultrasound evaluation of novel non-compliant versus conventional semi-compliant cutting balloon for calcified coronary lesions.Cardiovascular intervention and therapeutics · 2026Observational
- Intravascular Imaging-Guided Percutaneous Coronary Intervention for Calcified Coronary Lesions: A Network Meta-Analysis.JACC. Advances · 2026Article
- Intracoronary imaging in percutaneous coronary intervention: why, when, how and which from large, randomized trials.Nature reviews. Cardiology · 2026Review
- Optical Coherence Tomography-Guided Versus Angiography-Guided PCI in Moderate-to-Severe Calcified Coronary Lesions: A Systematic Review and Meta-Analysis of Randomized Trials.Diagnostics (Basel, Switzerland) · 2026Review
- Comparative Performance of Calcium-Modification Strategies for Coronary Lesions: A Network Meta-Analysis of Randomized Trials.Cardiovascular therapeutics · 2026Article
- Comparative effectiveness and outcomes of physiology- and imaging-guided PCI: an evidence synthesis and network meta-analysis of FFR, iFR, OCT, and IVUS.Frontiers in cardiovascular medicine · 2026Review
- The Role of Orbital Atherectomy for Complex Coronary Calcium Modification: Has It Been Eclipsed?Journal of personalized medicine · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
21 authors.
Funding
Abstract
BACKGROUND AND
aimsThe large-scale, randomized ILUMIEN IV trial was examined to determine whether procedural guidance with optical coherence tomography (OCT) during percutaneous coronary intervention (PCI) of angiographically calcified lesions improves outcomes.
methodsPatients with a single PCI target lesion were included in the present analysis. The presence of none, mild, moderate or severe lesion calcification was determined by an angiographic core laboratory. The primary imaging endpoint was the post-PCI minimal stent area (MSA) assessed by OCT. The primary clinical endpoint was 2-year target-vessel failure (TVF), a composite of cardiac death, target-vessel myocardial infarction (TV-MI), or ischaemia-driven target-vessel revascularization.
resultsIn the overall population (n = 2114), there was a significant interaction between the effect of randomization to OCT guidance vs angiography guidance in lesions with moderate/severe calcification (n = 1082) vs no/mild calcification (n = 1032) on the 2-year rate of TVF (Pinteraction = .01). The post-PCI MSA in moderately and severely calcified lesions was larger with OCT guidance (n = 544) compared with angiography guidance (n = 538) (5.57 ± 1.86 mm2 vs 5.33 ± 1.78 mm2; P = .03). In the moderate/severe calcified lesion cohort, TVF within 2 years occurred in 35 patients with OCT guidance and in 51 patients with angiography guidance (6.8% vs 9.7%; adjusted hazard ratio [aHR] 0.62; 95% confidence interval [CI] 0.40-0.96), whereas there was no significant difference in TVF in the no/mild calcified lesion cohort (7.7% vs 5.2%; aHR 1.48; 95% CI 0.90-2.44) (Pinteraction = .01). In moderately/severely calcified lesions, OCT-guided PCI also reduced the 2-year rates of serious major adverse cardiac events (2.8% vs 4.7%; aHR 0.49; 95% CI 0.25-0.95; P = .03), TV-MI (1.9% vs 4.0%; aHR 0.36; 95% CI 0.17-0.79; P = .01), and stent thrombosis (0.2% vs 1.5%; aHR 0.11; 95% CI 0.01-0.89; P = .04) compared with angiography-guided PCI.
conclusionsIn the ILUMIEN IV trial, OCT-guided PCI in patients with angiographically determined moderately or severely calcified lesions reduced the 2-year rate of TVF compared with angiography-guided PCI, an effect that was not seen in patients with lesions with no or mild angiographic calcium.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.