How many conferences, live workshops, where elite cardiologists, thought leaders (rather, academic influncers) , were projecting glittering power points about IVUS guided stent optimization, the sacred MLA’s , high precision POTS.They , sort of seduced us to believe , that these are going to rule the next generation PCIs .
In fact, some them warned us (with the company brand on the background) it’s a crime, to do any left main interventions without imaging.
Now, two back to back papers has come in NEJM* , exposing the futility of routine IVUS (after exhausting the market, and seeing no further scope for this deciet market ) . It simply unserscores the fact , that the good old luminogram is good enough for most PCIs including the complex ones *
Ironically , we should thank the same old companies, who for some reason , decided to stop this futility, by funding these studies.
Final message
The message from this study is , we should concentrate on the treatment of the whole burden of atherosclerosis. Let us not waste our resources to optimize the stent with exotic imaging , which can be done by conventional means.
Further, Cardiologists are obliged to apologize to their fellow physicians as well as the patient community for hyping up these unnecessary tools causing financial excess and promoting pseudo-science. They should also take an oath , they will not embrace the future technologies, prematurely and blindly.
Postamble
Waiting for OCT to go the same way as IVUS very soon. *By the way, I want to ask NEJM one question: Do you have any mechanism to identify these futilities earlier? Because you guys only publish and lift up the Iniital hypes.
Dr.S.Venkatesan MD 