Intravascular ultrasound

IVUS; Ultrasound - coronary artery; Endovascular ultrasound

Ultrasound uses sound waves to create moving images of organs and systems within the body. IVUS is a combination of a heart ultrasound (echocardiogram) and cardiac cathertization.

A tiny ultrasound wand is attached to the top of a tiny, hollow tube called a catheter. During the IVUS procedure, the ultrasound catheter is inserted into an artery in your groin area and moved up to the heart. This gives the health care provider a look at your arteries from the inside-out.

IVUS is often done during angioplasty. Angioplasty gives a general look at the coronary arteries, but can not show the walls of the arteries. IVUS images highlight the artery walls and can show if there are cholesterol and fat deposits (plaques). Build up of such plaque leads to hardening of the arteries (atherosclerosis).

IVUS has provided a great amount of insight into how stents become clogged (stent restenosis). The method has helped show that about 20% of cases of stent restenosis occur when the stent has not expanded properly.

IVUS may be used to:

• View the aorta and structure of the artery walls (which can show plaque build up)
• Identify which specific blood vessel is involved in aortic dissection
• Determine where a stent should be placed
• Discover how well angioplasty and stenting worked

There is a slight risk of complications associated with angioplasty and cardiac catheterization. However, the tests are very safe when performed by an experienced team. IVUS adds no additional risk.

Risks of angioplasty may include:

• Hemorrhage (bleeding) in area where the catheter was inserted
• Damage to a blood vessel
• Complete blockage of blood flow in a certain area
• Heart arrhythmias
• Allergic reaction to any dye used during the test
• Stroke

Risks of cardiac cathertization may include:

• Heart arrhythmias
• Cardiac tamponade
• Injury to the artery caused by a hematoma
• Low blood pressure
• Hemorrhage (bleeding)
• Stroke
• Heart attack
• Allergic reaction to any dye used during the test

After the test, the catheter is removed. A bandage is placed on the area. You will usually be asked to lie flat on your back for a few hours after the test to prevent bleeding.

If IVUS was done during cardiac catheterization, you will stay in the hospital for about 3 to 6 hours. If IVUS was done during angioplasty, you will stay in the hospital for 12 to 24 hours.

Grainger RG, Allison D, Adam A, Dixon AK. Grainger & Allison's Diagnostic Radiology: A Textbook of Medical Imaging. 4th ed. St. Louis, Mo: WB Saunders; 2001:70.

Sipahi I. Intravascular Ultrasound in the Current Percutaneous Coronary Intervention Era. Cardiol Clin. 2006 May; 24(2); 163-173.

Rowe VL . Advances in vascular imaging. Surg Clin North Am. 01-OCT-2004; 84(5): 1189-202, v.