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Virtual reality (VR), which represent immersive, computer-generated environments experienced through a head-mounted display, has been proposed as a potential tool across the PCI pathway. This narrative review synthesises literature from the last five years on four domains in which VR has been applied to PCI: (1) operator training and skill acquisition; (2) patient-specific pre-procedural planning and rehearsal; (3) intraprocedural visualisation and guidance (where VR overlaps with augmented and mixed reality); and (4) patient-centred applications including periprocedural anxiety and pain management, education, and rehabilitation after myocardial infarction or revascularisation. The evidence is heterogeneous and dominated by small studies, feasibility reports, and a growing number of randomised trials in the patient-anxiety domain. Immersive VR reduces periprocedural anxiety and represents the most clinically mature application to date, although its analgesic effect is less consistent and it has not proven non-inferior to pharmacological sedation for pain; VR-based simulation can transfer skills to real catheterisation laboratory performance; and patient-specific VR can support planning in anatomically complex PCI. The principal barriers are the absence of robust haptic feedback, cost, limited validation, cybersickness, and a scarcity of outcome-driven randomised trials. VR is best understood not as a competitor to digital twins, physics-based simulation, or augmented\/mixed reality, but as one complementary layer within a broader extended-reality ecosystem for coronary intervention. We outline priorities for future research, including standardised validation frameworks, integration with patient-specific digital twins, and adequately powered trials with clinical endpoints.<\/jats:p>","DOI":"10.1007\/s10554-026-03782-x","type":"journal-article","created":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T05:12:03Z","timestamp":1785388323000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Virtual reality in percutaneous coronary intervention: from coronary imaging and procedural planning to patient care"],"prefix":"10.1007","author":[{"given":"Ioannis","family":"Skalidis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giulia S.","family":"Beretta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Simioni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julius","family":"Jelisejevas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo Maria","family":"Cioffi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Wenaweser","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascal","family":"Meier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philippe","family":"Garot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Hovasse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariama","family":"Akodad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anastasios","family":"Apostolos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Panayotis K.","family":"Vlachakis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serban","family":"Puricel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Togni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephane","family":"Cook","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,7,30]]},"reference":[{"issue":"3","key":"3782_CR1","doi-asserted-by":"publisher","first-page":"519","DOI":"10.1016\/j.jcmg.2021.08.017","volume":"15","author":"C Jung","year":"2022","unstructured":"Jung C, Wolff G, Wernly B, Bruno RR, Franz M, Schulze PC, Silva JNA, Silva JR, Bhatt DL, Kelm M (2022) Virtual and augmented reality in cardiovascular care: state-of-the-art and future perspectives. 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