NEJM This Week — June 11, 2026

A groundbreaking study challenges the long-held assumption that intravascular ultrasound (IVUS) guidance improves outcomes in high-risk coronary interventions, revealing no significant benefit in reducing major adverse cardiac events—despite IVUS's established role in stent optimization. The trial's unexpected finding of a higher stroke rate in the IVUS-guided group raises urgent questions about procedural safety and the need to reevaluate how imaging is used in complex PCI. Meanwhile, researchers uncover a major molecular mechanism behind inflammatory bowel disease: neutralizing autoantibodies against interleukin-10, present in 3.5% of IBD patients and strongly linked to a specific HLA allele, offering a new path for targeted therapy. In a powerful personal reflection, a physician recounts the emotional toll of motherhood in medicine—how she internalized a myth of 'strength without allowance,' suppressing grief and joy alike—before realizing that carrying emotional weight is not a sign of weakness, but a shared human burden. These stories converge on a central theme: medicine must evolve beyond outdated frameworks, whether in imaging use, race-based prescribing, or the cultural expectation that clinicians must endure without support.