TCT 2026: CT-guided PCI Matches IVUS Outcomes in Randomized P4 Trial; Heartflow PCI Navigator Changes PCI Plans in Approximately 70% of Patients
Key Highlights
- ➤P4 trial: CT-guided PCI matched IVUS, with 12-month target-vessel failure of 4.1% versus 4.6%
- ➤CT-guided PCI cut median procedure time 17 minutes versus IVUS, a 27% reduction
- ➤NAVIGATE-PCI changed treatment plans in approximately 70% of patients versus angiography alone
- ➤Heartflow PCI Navigator most frequently changed stent length in 41% of patients
- ➤BRAVEHEART found subclinical coronary plaque in 72% of asymptomatic firefighters
Expert Statements
Campbell Rogers, Chief Medical Officer at Heartflow
“CT has already become routine for planning structural procedures like TAVR. The data presented at TCT show coronary intervention is ready to follow the same path with advanced pre-procedural imaging and Heartflow’s AI-powered analysis to deliver precision and efficiency.”
Campbell Rogers, Chief Medical Officer at Heartflow
“What we learned planning P4 cases across six separate tools shaped Heartflow PCI Navigator, which brings anatomy, plaque and physiology together in the first and only PCI planning tool backed by prospectively validated accuracy and randomized clinical trial data. Together, P4 and NAVIGATE-PCI support a paradigm shift in coronary intervention, bringing non-invasive CT-guided PCI planning into routine cath lab practice.”
Carlos Collet, Principal investigator of the P4 trial and Director of Cardiovascular Imaging, Physiology and Translational Therapeutics at the Cardiovascular Research Foundation in New York
“Intravascular ultrasound is an established benchmark, but performing assessments inside the cath lab adds procedural time and requires expertise.”
Carlos Collet, Principal investigator of the P4 trial and Director of Cardiovascular Imaging, Physiology and Translational Therapeutics at the Cardiovascular Research Foundation in New York
“P4 shows that non-invasive CT-guided PCI planning achieves comparable clinical outcomes with shorter procedure times and less contrast, enabling interventionalists to anticipate challenges, tailor their strategy, and enter the cath lab better prepared.”
Ziad A. Ali, Principal investigator of the NAVIGATE-PCI registry and Director of the DeMatteis Cardiovascular Institute at St. Francis Heart Center in New York
“Angiography only shows a two-dimensional silhouette, leaving critical blind spots around plaque burden, calcium and true vessel size.”
Ziad A. Ali, Principal investigator of the NAVIGATE-PCI registry and Director of the DeMatteis Cardiovascular Institute at St. Francis Heart Center in New York
“Heartflow PCI Navigator fundamentally changes our approach, providing the comprehensive 3D and physiologic clarity needed to tailor treatment plans with greater confidence before entering the cath lab.”
Late-Breaking P4 study, simultaneously published in NEJM, shows CT guidance delivers matched one-year clinical outcomes with shorter procedures, demonstrating pre-procedural CCTA can guide key PCI planning decisions
NAVIGATE-PCI shows Heartflow PCI Navigator drove modifications to stent length and lesion prep compared to angiography alone
Get started
Create a free account to read the full story.