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What Is the Clinical Utility of Intravascular Ultrasound?

  • Echocardiography (JM Gardin and AH Waller, Section Editors)
  • Published:
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Abstract

Purpose of Review

This article reviews the contemporary evidence base for use of coronary intravascular ultrasound (IVUS).

Recent Findings

Recent studies have strongly associated IVUS guidance during percutaneous coronary angioplasty (PCI) with lower major adverse cardiac events (MACE), stent thrombosis, and in selected groups, mortality. The PROSPECT study found in acute coronary syndromes patients, IVUS-determined minimal luminal area ≤ 4.0 mm2 and the presence of thin-cap fibroatheromas were independent predictors of future MACE in non-culprit lesions. A sub-analysis of the ADAPT-DES trial demonstrated significant reductions in stent thrombosis, myocardial infarction, and composite MACE in patients with IVUS-guided PCI versus angiography alone. In patients with cardiac allograft vasculopathy, IVUS measurements of intimal thickening and attenuated-signal plaque are associated with increased mortality.

Summary

IVUS has become a ubiquitous and versatile adjunct to conventional angiography. It is a powerful tool for identification and assessment of atherosclerotic disease, guidance of percutaneous coronary intervention, and detection of cardiac allograft vasculopathy.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. Department of Medicine, University of Chicago Medicine, 5841 South Maryland Avenue, MC 5000, Chicago, IL, 60637, USA

    Eisha Wali

  2. Section of Cardiology, University of Chicago Medicine, 5841 South Maryland Avenue, MC 5076, Chicago, IL, 60637, USA

    Sandeep Nathan

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Correspondence to Sandeep Nathan.

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Wali, E., Nathan, S. What Is the Clinical Utility of Intravascular Ultrasound?. Curr Cardiol Rep 20, 122 (2018). https://doi.org/10.1007/s11886-018-1062-z

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