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- angiography has major limitations in its ability to assess coronary disease
- intravascular ultrasound (IVUS) offers unique capabilities to assess coronary
atherosclerotic burden. The tomographic orientation of ultrasound enables
visualization of the full vessel wall, as opposed to the 2-dimensional projection
of the lumen provided by angiography.
- the equipment required to perform coronary IVUS consists of a catheter with
a miniaturized transducer and a console to reconstruct the image. High ultrasound
frequencies are used, typically, 30 to 40 MHz, which provides excellent theoretical
resolution. IVUS has been performed safely in a wide variety of clinical situations.
Vessels with classic atherosclerosis exhibit a diversity of abnormal features
that reflect the severity, composition, and distribution of the atheromata.
Plaque rupture is sometimes evident in ultrasound examination of the culprit
lesions after an acute coronary syndrome. Most laboratories routinely perform
cross-sectional area measurements of the lumen and external elastic membrane
boundaries and calculate atheroma area
- IVUS commonly detects atherosclerosis at angiographically normal sites.
It has contributed substantially to our understanding of remodeling and has
shown that positive remodeling is more prevalent in unstable lesions. Studies
in patients early after transplantation have shown the presence of advanced
atherosclerosis in their apparently normal donors. In addition, the application
of IVUS in detecting the rate of progression or regression of existing atherosclerosis
is among the most dynamic areas of development. IVUS is likely to emerge as
the "gold standard" in the study of atherosclerosis progression-regression
over the next few years.
J Cardiol 2002 Feb 21;89(4A):24B-31
Last reviewed 01/2018