Although clinical outcomes after percutaneous coronary intervention (PCI) are improving, the long-term risk for target vessel failure remains concerning. Although the application of intravascular imaging and physiological indexes significantly improves outcomes, their routine use in practice remains limited. Nevertheless, merely using these modalities is not enough, and to truly improve patient outcomes, optimal intravascular dimensions with minimal vascular injury should be targeted. When assessing post-PCI results using either type of physiological or imaging technology, a broad spectrum of stent- and vessel-related anomalies can be expected. As not all of these issues warrant treatment, a profound knowledge of what to expect and how to recognize and when to treat these intraluminal problems is needed. Additionally, promising new modalities such as angiography-derived coronary physiology and hybrid imaging catheters are becoming available. The authors provide an overview of the currently available tools and techniques to define suboptimal PCI and when to apply these technologies to improve outcomes.

尽管经皮冠状动脉介入治疗 (PCI) 后的临床结果正在改善，但靶血管衰竭的长期风险仍然令人担忧。尽管血管内成像和生理指标的应用显着改善了结果，但它们在实践中的常规使用仍然有限。然而，仅仅使用这些方式是不够的，为了真正改善患者的预后，应以血管损伤最小的最佳血管内尺寸为目标。在使用任一类型的生理或成像技术评估 PCI 后结果时，可以预期广泛的支架和血管相关异常。由于并非所有这些问题都需要治疗，因此需要深入了解会发生什么以及如何识别以及何时治疗这些管腔内问题。此外，有前途的新模式，如血管造影衍生的冠状动脉生理学和混合成像导管正在变得可用。作者概述了当前可用的工具和技术来定义次优 PCI，以及何时应用这些技术来改善结果。