Updated: Sep 14
Percutaneous coronary intervention (PCI), is a common procedure used to open blocked coronary arteries. This improves blood flow to the heart and relieves symptoms of coronary artery disease. During PCI, a catheter with a balloon is threaded through the artery to the site of the blockage. The balloon is inflated to compress the plaque and widen the artery. Often, a stent is also placed to help keep the artery open.
Intravascular ultrasound (IVUS) is an imaging technology that can be used during PCI to visualize the coronary arteries from the inside out. An IVUS catheter with a miniaturized ultrasound transducer is advanced into the coronary arteries, providing a cross-sectional view of the vessel wall and lumen.
IVUS offers several benefits during PCI:
Assesses adequacy of stent expansion - IVUS is superior to angiography for determining if a stent is fully apposed to the arterial wall. Under-expanded stents are at higher risk of thrombosis and restenosis. IVUS ensures proper stent placement and expansion.
Measures plaque burden - IVUS can quantify the amount of plaque in the vessel and determine the adequacy of plaque modification before stent placement. This helps optimize stent sizing and placement.
Identifies mechanical complications - Dissections, tissue protrusions, incomplete apposition, and edge dissections are complications that may be missed on angiography but detected with IVUS. This allows operators to address issues promptly before the patient leaves the cath lab.
Evaluates intermediate coronary lesions - IVUS helps determine which ambiguous narrowings seen on angiography are truly flow-limiting. This guides decision making around which lesions require stenting.
Assesses results post-intervention - IVUS is used at the end of PCI to ensure the desired outcome was achieved and identify any needed modifications before ending the procedure.
IVUS during PCI offers valuable anatomical and physiological insights that can optimize stent delivery and improve procedural outcomes. Wider adoption of this technology may lead to improved PCI safety and efficacy.
In recognition of the pivotal role that IVUS plays in optimizing PCI outcomes, ADN CoE is holding an IVUS training session and CTO PCI training sessions in istanbul and Italy. These sessions are designed to empower cardiologists with the knowledge and skills needed to harness the full potential of IVUS and excel in the management of complex CTO cases, Check website for more details.