In this episode, we delve into the RENOVATE-COMPLEX-PCI trial, a pivotal study evaluating the efficacy of intravascular imaging-guided percutaneous coronary intervention (PCI) compared to traditional angiography-guided PCI in patients with complex coronary artery disease. The trial demonstrated that using intravascular imaging techniques, such as intravascular ultrasound (IVUS) or optical coherence tomography (OCT), led to a significant reduction in target vessel failure rates. We explore the study's design, key findings, and discuss how these results are influencing current interventional cardiology practices.