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IVUS Guidance

Abstract

Recommended Article

The relationship between attenuated plaque identified by intravascular ultrasound and no-reflow after stenting in acute myocardial infarction: the HORIZONS-AMI (Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction) trial Impact of intravascular ultrasound guidance in routine percutaneous coronary intervention for conventional lesions: data from the EXCELLENT trial Effects of Intravascular Ultrasound-Guided Versus Angiography-Guided New-Generation Drug-Eluting Stent Implantation: Meta-Analysis With Individual Patient-Level Data From 2,345 Randomized Patients Impact of plaque components on no-reflow phenomenon after stent deployment in patients with acute coronary syndrome: a virtual histology-intravascular ultrasound analysis Comprehensive intravascular ultrasound assessment of stent area and its impact on restenosis and adverse cardiac events in 403 patients with unprotected left main disease Differential prognostic effect of intravascular ultrasound use according to implanted stent length Comparison of intravascular ultrasound versus angiography-guided drug-eluting stent implantation: a meta-analysis of one randomised trial and ten observational studies involving 19,619 patients Impact of intravascular ultrasound guidance on long-term mortality in stenting for unprotected left main coronary artery stenosis

Review Article2017 Aug 19;390(10096):793-809.

JOURNAL:Lancet. Article Link

Intravascular imaging in coronary artery disease

Mintz GS, Guagliumi G. Keywords: Intravascular imaging

ABSTRACT


Although it is the method used by most interventional cardiologists to assess the severity of coronary artery disease and guide treatment, coronary angiography has many known limitations, particularly the fact that it is a lumenogram depicting foreshortened, shadowgraph, planar projections of the contrast-filled lumen rather than imaging the diseased vessel itself. Intravascular imaging-intravascular ultrasound and more recently optical coherence tomography-provide a tomographical or cross-sectional image of the coronary arteries. These techniques are clinically useful to answer questions such as whether the stenosis is clinically relevant; the identification of the culprit lesion; or whether the plaque (or patient) is at high risk of future adverse events. They can also be used to optimise stent implantation to minimise stent-related adverse events, provide answers to the likelihood of distal embolisation or peri-procedural myocardial infarction during stent implantation, and provide reasons for stent thrombosis or restenosis. This review considers the usefulness of intravascular imaging in day-to-day practice.