CCTA-guided PCI noninferior to IVUS-guided PCI at 12 months

In the P4 trial, a strategy for guiding percutaneous coronary intervention (PCI) with coronary computed tomographic angiography (CCTA) was noninferior to one guided by intravascular ultrasound (IVUS) for target-vessel failure at 12 months. The findings were presented at TCT 2026 and published in the New England Journal of Medicine, according to ACC.

Researchers randomized 1,105 patients with a clinical indication for revascularization, at least one epicardial lesion with a diameter stenosis of more than 70%, and a fractional flow reserve of 0.80 or less. Target-vessel failure occurred in 23 patients (4.1%) in the CCTA-guided group and 25 patients (4.6%) in the IVUS-guided group. Clinical procedural complications occurred in 6 patients assigned to CCTA-guided PCI and 9 assigned to IVUS-guided PCI.