India, March 15 -- Coronary artery disease remains a leading cause of morbidity and mortality worldwide. While conventional percutaneous coronary intervention (PCI) has proven effective in relieving ischemia, it often relies on angiographic interpretation, which provides only a two-dimensional view of complex coronary anatomy. This limitation can lead to inappropriate stent sizing, suboptimal expansion, and variable long-term outcomes. Precision PCI seeks to address these shortcomings through advanced intravascular imaging, functional assessment, and individualised procedural planning. The foundation of precision PCI lies in intravascular imaging and physiological lesion assessment. Multiple randomised trials have validated the superiority of image and physiology-guided PCI over angiography alone. The ULTIMATE demonstrated a significant reduction in target vessel failure with IVUS guidance. Similarly, the ILUMIEN III showed improved stent optimisation, while the DEFINE-FLAIR confirmed that functional guidance reduces unnecessary interventions without compromising safety. These findings underscore the clinical value of precision-based techniques in improving both short- and long-term outcomes. Precision PCI represents a paradigm shift from a visually estimated procedure to a data-driven, patient-specific therapy. By integrating anatomical and physiological data, interventional cardiologists can tailor interventions to individual patient needs, reducing restenosis, stent thrombosis and repeat revascularization. Moreover, this approach fosters a culture of evidence-based, reproducible practice, aligning with modern principles of precision medicine. Precision PCI embodies the future of coronary intervention by merging imaging, physiology, and personalised strategy to achieve superior procedural and clinical outcomes. As technological innovations and artificial intelligence continue to evolve, the precision paradigm will further refine patient selection, lesion assessment and stent optimisation, setting new standards in the treatment of coronary artery disease....