Authors
Asahi Oshima, Pruthvi C Revaiah, Nozomu Kanehama, Adrian Wlodarczak, Helge Möllmann, Raul Moreno, Milosz Dziarmaga, Manel Sabaté, Jacek Legutko, Marc Silvestri, Julien Lemoine, Anirban Choudhury, Hüseyin Ince, Alper Öner, Faisal Sharif, Simone Biscaglia, Janusz Kochman, Joanna Wykrzykowska, Maciej Lesiak, Ignacio J Amat-Santos, Abhishek Kumar, Nicolas Meneveau, Martin Landt, Michael Magro, Azfar Zaman, Murugapathy Veerasamy, Giuseppe Tarantini, Bruno Farah, Peter O'kane, Bruno Garcia Del Blanco, Joan Antoni Gomez-Hospital, Robert Jozwa, Thomas Schmitz, Richard Anderson, Stephan Achenbach, Angela Hoye, Andrew McNeice, Alexander Lauten, Eric Van Belle, Stanislaw Bartus, Piotr Wacinski, Sen Devadathan, Adrian Bednarek, Szymon Wlodarczak, Aishwarya Gurav, Jacopo Farina, Gonçalo Ferraz-Costa, Jerzy Paluszkiewicz, Kotaro Miyashita, Akihiro Tobe, Albert Chinhenzva, Scot Garg, Sofia Sunny, Gráinne Ní Bheoláin, Emma Harte, Tsung-Ying Tsai, Yoshinobu Onuma, Patrick W Serruys
Published in
EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology. Volume 22. Issue 19. Pages e1048-e1063. Oct 05, 2026. Epub Oct 05, 2026.
Abstract
The European Association of Percutaneous Cardiovascular Interventions (EAPCI)-endorsed algorithm for defining device success has not yet been prospectively tested against standardised quantitative coronary angiography (QCA) by a core lab.
We sought to assess whether visually evaluated device success by the operator at the end of percutaneous coronary intervention (PCI) aligns with the EAPCI-endorsed standardised definition adjudicated by the core lab and to evaluate its association with clinical outcomes.
This prespecified analysis of the Multivessel TALENT trial included 1,548 patients with three-vessel disease randomised to treatment with either Supraflex Cruz or SYNERGY stents. PCI was attempted in 4,052 lesions. The core lab assessed post-PCI residual in-stent percentage diameter stenosis (%DS) by QCA (target <20%) and exploratory delta (Δ) angiography-derived fractional flow reserve (angio-FFR) across the stent(s) (target <0.05). Device success was evaluated using the site-reported data (visual evaluation of in-stent %DS), core lab QCA, core lab angio-FFR, and combined core lab QCA+angio-FFR. The lesion-oriented composite endpoint (LOCE; comprising cardiovascular death, target vessel myocardial infarction, or target lesion revascularisation) was assessed at 1 year.
Site-reported device success was 97.4%. Core lab definitions yielded lower rates: 93.8% for Δangio-FFR <0.05, 88.0% for residual %DS <20%, and 83.2% for QCA+angio-FFR (all p<0.001 vs site report after Bonferroni correction). Lesions not meeting QCA-based device success had a higher incidence of LOCE than those meeting the definition (12.0% vs 9.1%; log-rank p=0.041). Device success and LOCE rates did not differ between the two stents for any definition.
In this prespecified lesion-level substudy, standardised assessment using the EAPCI device success algorithm with core lab QCA reclassified a substantial proportion of operator-adjudicated successes and identified lesions at higher 1-year LOCE risk. (ClinicalTrials.gov: NCT04390672).
PMID:
42837202
Bibliographic data and abstract were imported from PubMed on 07 Oct 2026.
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