Intravascular ultrasound

Summary

Intravascular ultrasound (IVUS) was the first intravascular coronary imaging technique to be developed. From its inception, it was designed to overcome the limitations of angiographic luminography. This technique has made significant contributions to our current understanding of coronary artery disease through its capacity to obtain in vivo images of the vessel wall structure and its interaction with coronary devices. Knowledge of coronary vessel remodelling during atherogenesis is largely based on IVUS evidence, and many progression/regression studies of atherosclerosis are IVUS-based.

In addition, IVUS has played a key role in the field of percutaneous coronary interventions (PCI), depicting the pitfalls of stent deployment and improving stenting techniques, a major step which has dramatically decreased periprocedural complications allowing the use of the simpler antithrombotic treatments employed today and has also contributed to a decrease in long-term major cardiovascular events (MACE).

In complex subsets of PCI, IVUS is an indispensable tool, and newer IVUS catethers are being comercialized which are high definition in nature. These trends will be reviewed in this chapter, along with a review of the most important uses of IVUS in current research and clinical practice.

Introduction

Atherosclerosis is the main cause of coronary heart disease, which is today...