Intravascular ultrasound: (CONSULTANT-LEVEL EXAMINATION)

Overview

Since its advent in 1977, percutaneous coronary intervention (PCI) has become a dominant treatment modality for ischemic coronary artery disease, especially unstable angina and acute myocardial infarction. During the last 2 decades, intravascular ultrasound (IVUS), a catheter-based technique that provides tomographic images perpendicular to the length of the coronary arteries, has been used widely in clinical research and has contributed to technologic improvements in interventional cardiology because it provides invaluable information on the coronary vascular lumen and wall. IVUS uses high-frequency catheter-based transducers to visualize all basic components of the vessel: the cross-sectional luminal size, shape, and vessel wall, as well as the various layers of the wall such as the intima, media, and adventitia and perivascular structures. IVUS examination of the carotid arteries may enable the morphologic characteristics of the carotid lesions to be assessed and thus treatment to be optimized. IVUS evaluation of the venous circulation is still limited. However, the method has been used to study arteriovenous malformations and mainly to demonstrate inferior vena cava compression or thrombosis, as well as to guide stent and filter placement.