Gotta love wikipedia:
Disadvantages versus angiography[edit]
The primary disadvantages of IVUS being used routinely in a cardiac catheterization laboratory are its expense, the increase in the time of the procedure, and the fact that it is considered an interventional procedure, and should only be performed by angiographers that are trained in interventional cardiology techniques. In addition, there may be additional risk imposed by the use of the IVUS catheter.
The computerized IVUS echocardiographic imaging systems list for $120,000, US, 2007 for a cart based system and ~$70,000 for an installed or integrated solution. The disposable catheters used to do each examination typically cost ~$600, US, 2007. In many hospitals, the IVUS system is placed as part of a bundle deal based on minimum disposable sales volumes. In other words, the cost of the console is paid for by rebates from other purchased products including IVUS catheters. Because no standard exists, IVUS catheters cannot be interchanged between different manufacturers.
Additionally, IVUS adds significant additional examination time and some increased risk to the patient beyond performing a standard diagnostic angiographic examination. This increase is significantly less when IVUS is part of a percutaneous coronary intervention, since much of the setup is the same for the intervention as for the IVUS imaging.
IVUS continues to improve and some manufacturers have proposed building IVUS technology into angioplasty and stent balloon catheters, a potential major advance, but limited by complexity, cost and increased bulk of the catheters.
Afaik, in the developed countries FFR is standard done during the angiographic procedure.
The outcome of the FFR measurements guides the cardiologist in the decision if the patient will benefit from a stent placement or not.
IVUS is not used standard. Some cardiologists use it occasionally, in difficult cases, or to assist in the selection and sizing of stents and balloons. Others use it routinely, to confirm accurate stent placement and optimal stent deployment.
I guess, in a couple of year it will be routinely used by all cardiologists/interventionalists. Now it is perhaps used only by the early adapters.
Although the IVUS tool can help in diagnosis and in treatment it will make the whole angiographic procedure take more time.
I can imagine that in straightforward cases, diagnosis is easy without IVUS. It then makes sense to stop the procedure asap without the use of IVUS.
Afaik, in the developed countries FFR is standard done during the angiographic procedure.
The outcome of the FFR measurements guides the cardiologist in the decision if the patient will benefit from a stent placement or not.
IVUS is not used standard. Some cardiologists use it occasionally, in difficult cases, or to assist in the selection and sizing of stents and balloons. Others use it routinely, to confirm accurate stent placement and optimal stent deployment.
I guess, in a couple of year it will be routinely used by all cardiologists/interventionalists. Now it is perhaps used only by the early adapters.
Although the IVUS tool can help in diagnosis and in treatment it will make the whole angiographic procedure take more time.
I can imagine that in straightforward cases, diagnosis is easy without IVUS. It then makes sense to stop the procedure asap without the use of IVUS.