{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T14:48:18Z","timestamp":1787323698481,"version":"build-2736575974"},"reference-count":18,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100011699","name":"Siemens Healthineers","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100011699","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Optimal stent expansion is a key determinant of long\u2010term outcomes after PCI. Intravascular imaging provides the most accurate assessment of stent deployment but remains underused, especially in older patients with MI and multivessel disease. ESV is an angiographic enhancement technology that may help detect gross stent underexpansion when advanced imaging is not feasible.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To evaluate the procedural and clinical impact of enhanced stent visualization (ESV)\u2010guided percutaneous coronary intervention (PCI) in older patients with myocardial infarction (MI) and multivessel disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prespecified sub\u2010study of the FIRE trial, we evaluated the impact of ESV use during PCI in older MI patients. Among 1445 enrolled patients, 331 underwent ESV\u2010guided PCI and 1114 standard angiography\u2010guided PCI. Procedural optimization triggered by ESV was defined as additional postdilation, extra stent implantation, or use of intravascular imaging. Minimal lumen diameter (MLD) was assessed before and after ESV\u2010guided optimization. Clinical outcomes were compared using multivariable and competing\u2010risk adjusted Cox models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Operator\u2010driven optimization occurred in 85% of ESV cases, primarily through postdilation (96%). ESV guidance resulted in a significant MLD increase from 2.51 [2.22\u20132.87] to 2.93 [2.41\u20133.32]\u2009mm (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), yielding an acute luminal gain of 0.42\u2009mm (95% CI 0.37\u20130.47). At 3 years, the composite primary endpoint (death, MI, stroke, or ischemia\u2010driven revascularization) was lower in the ESV group (adjusted HR 0.70, 95% CI 0.54\u20130.91;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In older MI patients with complex multivessel disease, ESV\u2010guided PCI was associated with greater procedural optimization, improved acute stent expansion, and lower long\u2010term adverse events. While not a substitute for intracoronary imaging, ESV represents a pragmatic and valuable adjunct to enhance PCI quality in settings where intravascular imaging is seldom performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov identifier NCT03772743.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.70819","type":"journal-article","created":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T14:12:17Z","timestamp":1787321537000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluating the Impact of Enhanced Stent Visualization on PCI Outcomes in Older Patients With Multivessel Disease"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4280-5232","authenticated-orcid":false,"given":"Marta","family":"Cocco","sequence":"first","affiliation":[{"name":"Cardiology Unit Azienda Ospedaliero\u2010Universitaria di Ferrara Ferrara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1185-1830","authenticated-orcid":false,"given":"Alberto","family":"Sarti","sequence":"additional","affiliation":[{"name":"Cardiology Unit Azienda Ospedaliero\u2010Universitaria di Ferrara Ferrara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0760-6609","authenticated-orcid":false,"given":"Filippo Maria","family":"Verardi","sequence":"additional","affiliation":[{"name":"Cardiology Unit Azienda Ospedaliero\u2010Universitaria di Ferrara Ferrara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8222-9236","authenticated-orcid":false,"given":"Serena","family":"Caglioni","sequence":"additional","affiliation":[{"name":"Cardiology Unit Azienda Ospedaliero\u2010Universitaria di Ferrara Ferrara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9198-2600","authenticated-orcid":false,"given":"Jacopo","family":"Farina","sequence":"additional","affiliation":[{"name":"Cardiology Unit Azienda Ospedaliero\u2010Universitaria di Ferrara Ferrara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo","family":"Penzo","sequence":"additional","affiliation":[{"name":"Cardiology Unit Azienda Ospedaliero\u2010Universitaria di Ferrara Ferrara 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Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8125-5536","authenticated-orcid":false,"given":"Anna","family":"Cantone","sequence":"additional","affiliation":[{"name":"Cardiology Unit Azienda Ospedaliero\u2010Universitaria di Ferrara Ferrara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0505-5292","authenticated-orcid":false,"given":"Andrea","family":"Erriquez","sequence":"additional","affiliation":[{"name":"Cardiology Unit Azienda Ospedaliero\u2010Universitaria di Ferrara Ferrara Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5150-188X","authenticated-orcid":false,"given":"Gianluca","family":"Campo","sequence":"additional","affiliation":[{"name":"Cardiology Unit Azienda Ospedaliero\u2010Universitaria di Ferrara Ferrara 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