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Intravascular Ultrasound in Endovascular Interventions for Peripheral Artery Disease

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Abstract

Purpose of review

This article reviews the contemporary evidence for the use of intravascular ultrasound (IVUS) for peripheral arterial disease (PAD) endovascular interventions.

Recent findings

Earlier observational studies have shown that IVUS use for endovascular interventions is associated with improved patency rates and freedom from restenosis. Recently, a randomized trial demonstrated that IVUS was associated with a significantly larger mean vessel diameter than angiography, higher freedom from binary restenosis at 12 months. Recent large observational studies have suggested that IVUS is also associated with improved clinical outcomes. One study of 543,488 Medicare beneficiaries showed that IVUS use was associated with lower risk of major adverse limb events, including amputation and arterial thrombosis. Another Japanese analysis of 85,649 showed that the IVUS was associated with lower incidence of amputation at 12 months.

Summary

The benefit of IVUS use in coronary interventions is well established, but the translation of these benefits to endovascular interventions has lagged behind, with a growing body of evidence supporting its use, mainly observational studies. Randomized trials are emerging to better document the benefit of IVUS in endovascular interventions.

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References and Recommended Reading

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

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Authors and Affiliations

  1. Faculty of Medicine, Menoufia University, Shibin Al Kawm, Egypt

    Mohamed Khedr MD

  2. Willis Knighton Heart Institute, Shreveport, LA, USA

    Michael Megaly MD, MS

  3. Division of Cardiovascular Medicine, Gill Heart Institute, University, of Kentucky, 900 S. Limestone St, Lexington, KY, USA

    Islam Y. Elgendy MD, FACC, FAHA, FSCAI, FSVM, FESC, FACP

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  1. Mohamed Khedr MD
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  2. Michael Megaly MD, MS
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  3. Islam Y. Elgendy MD, FACC, FAHA, FSCAI, FSVM, FESC, FACP
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Correspondence to Islam Y. Elgendy MD, FACC, FAHA, FSCAI, FSVM, FESC, FACP.

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Mohamed Khedr declares that he has no conflict of interest. Michael Megaly declares that he has no conflict of interest. Islam Y. Elgendy declares that he has no conflict of interest.

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Khedr, M., Megaly, M. & Elgendy, I.Y. Intravascular Ultrasound in Endovascular Interventions for Peripheral Artery Disease. Curr Treat Options Cardio Med 25, 347–358 (2023). https://doi.org/10.1007/s11936-023-00997-2

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