How clinically effective is intravascular ultrasound in interventional cardiology? Present and future perspectives

Abstract

Intravascular ultrasound (IVUS) has been clinically available for almost 25 years now and showed us valuable information regarding the coronary vessel lumen, its dimensions, the plaque burden and plaque characteristics that we were not able to assess by angiography alone. Using these abilities, IVUS has helped us to start, understand the atherosclerotic process in the coronary vessels. Further technical innovations partially overcame the somewhat limited image resolution of IVUS allowing more in-depth characterization and quantification of coronary plaque components. In addition, IVUS has been shown to be helpful to guide interventional procedures including optimal stent deployment in many clinical situations. In this review, we focus on the potential role of IVUS technology in interventional cardiology and on the valuable role of IVUS usage in percutaneous coronary interventions.

Keywords::

• coronary interventions
• computer assisted
• coronary artery
• coronary vessels/ultrasonography
• disease/pathology/*ultrasonography
• image interpretation
• interventional/*methods
• treatment outcome
• ultrasonography

Financial & competing interests disclosure

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• • Intravascular ultrasound (IVUS) is uniquely capable presenting not only the lumen but also the coronary vessel wall.

• • IVUS has been around for more than two decades and there is large knowledge, and databases full, about its clinical usefulness.

• • IVUS is capable to provide, within limits, qualitative and quantitative information about the composition of the atherosclerotic plaques in coronary arteries.

• • In complex angiographic stenosis IVUS can provide additional crucial information to help in strategy selection and to guide the procedure.

• • In the future multi-modality interventional suites, IVUS will be side-by-side with newer modalities such as optical coherence tomography, having a crucial role as these modalities are not competitors but are complementary.