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Arterial and Venous Intravascular Ultrasound Applications

Chapter

Abstract

Intravascular ultrasound (IVUS) is a catheter based endovascular guidance system which was developed initially in interventional cardiology but has been very successfully translated to peripheral interventions. The catheters are small with tiny transducers which can be easily introduced over a guidewire percutaneously. Because the ultrasound probe is introduced at such close proximity to the vessel, great detail and therefore important information of the disease can be obtained. IVUS is an expensive imaging modality and its use has tended to be for the more complex cases such as endoluminal grafting, carotid stenting, or cases of critical limb ischemia. However, the ability for the operating room to successfully use IVUS in such situations depends on a regular ability to use and understand its clinical value. Fortunately IVUS has become much more readily understandable and user friendly in the operating room not only with technical improvements in catheters but also within the IVUS machine operator interface as well as with advances such as three-dimensional reconstruction, color flow, and virtual histology (VH). This latest development of VH IVUS has led to a greater appreciation of plaque type and how the disease in the wall of the vessel will behave at the moment of endoluminal treatment. The role of IVUS is expanding to assist with endovenous interventions. Further advances in IVUS are likely to come from forward looking IVUS, which may help negotiate chronic total occlusions. There is no doubt that the role and use of IVUS in peripheral interventions are increasing and the cost effectiveness and clinical value are becoming more practical and established.

Keywords

Intravascular ultrasound Virtual histology 

References

  1. 1.
    Diethrich EB. Endovascular treatment of abdominal occlusive disease; the impact of stents and intravascular ultrasound imaging. Eur J Surg. 1993;7:228–36.Google Scholar
  2. 2.
    Laskey WK, Brady ST, Kussmaul WG. Intravascular ultrasonographic assessment of the results of coronary artery stenting. Am Heart J. 1993;125(6):1576–83.PubMedCrossRefGoogle Scholar
  3. 3.
    White RA, Scoccianti M, Back M, et al. Innovations in vascular imaging; arteriography, three-dimensional CT scans, and two and three dimensional intravascular ultrasound evaluation of an abdominal aortic aneurysm. Ann Vasc Surg. 1994;8(3):285–9.PubMedCrossRefGoogle Scholar
  4. 4.
    Irshad K, Rahman N, Bain D. The role of intravascular ultrasound and peripheral endovascular interventions. In: Heuser RR, Henry M, editors. Textbook of peripheral vascular interventions. London: Martin Dunitz; 2004. p. 25–34.Google Scholar
  5. 5.
    Irshad K, Reid DB, Miller PH, et al. Early clinical experience with color three-dimentional intravascular ultrasound in peripheral interventions. J Endovasc Ther. 2001;8:329–38.PubMedCrossRefGoogle Scholar
  6. 6.
    Reid DB, Douglas M, Diethrich EB. The clinical value of three-dimentional intravascular ultrasound imaging. J Endovasc Surg. 1995;2:356–64.PubMedCrossRefGoogle Scholar
  7. 7.
    Reid DB, Diethrich EB, Marx P, Wrasper R. Clinical application of intravascular ultrasound in peripheral vascular disease. In: Seigel RJ, editor. Intravascular ultrasound imaging in coronary artery disease. New York: Marcel Dekker; 1998. p. 309–41.Google Scholar
  8. 8.
    Gussenhoven EJ, van der lugt A, Pasterkamp G. Intravascular ultrasound predictors of outcome after peripheral balloon angioplasty. Eur J Vasc Endovasc Surg. 1995;10:279–88.PubMedCrossRefGoogle Scholar
  9. 9.
    Cavaye DM, Diethrich EB, Santiago OJM, et al. Intravascular ultrasound imaging: an essential component of angioplasty assessment and vascular stent deployment. Int Angiol. 1993;12:212–20.Google Scholar
  10. 10.
    Katzen BT, Benenati JF, Becker GJ, et al. Role of intravascular ultrasound in peripheral atherectomy and stent deployment. Circulation. 1991;84:2152. Abstract.Google Scholar
  11. 11.
    Vince DG, Davies SC. Peripheral application of intravascular ultrasound virtual histology. Semin Vasc Surg. 2004;17:119–25.PubMedCrossRefGoogle Scholar
  12. 12.
    Kuchalakanti P, Rha SW, Cheneau E. Identification of “vulnerable plaque” using virtual histology in angiographically benign looking lesion of proximal left anterior descending artery. Cardiovasc Radiat Med. 2003;4(4):225–7.CrossRefGoogle Scholar
  13. 13.
    Nair A, Kuben BD, Obuchowski N, Vince DG. Assessing spectral algorithms to predict atherosclerotic plaque composition with normalized and raw intravascular ultrasound data. Ultrasound Med Biol. 2001;27(10):1319–31.PubMedCrossRefGoogle Scholar
  14. 14.
    Nair A, Kuban BD, Tuzcu EM, et al. Coronary plaque classification with intravascular ultrasound radiofrequency data analysis. Circulation. 2002;106:2200–6.PubMedCrossRefGoogle Scholar
  15. 15.
    Schartl M, Bocksch W, Koschyk DH, et al. Use of intravascular ultrasound to compare effects of different strategies of lipid-lowering therapy on plaque volume and composition in patients with coronary artery disease. Circulation. 2001;104:387–92.PubMedCrossRefGoogle Scholar
  16. 16.
    Diethrich EB, Ndiaye M, Reid DB. Stenting in the carotid artery: initial experience in 110 patients. J Endovasc Surg. 1996;3:42–62.PubMedCrossRefGoogle Scholar
  17. 17.
    Reid DB, Diethrich EB, Marx P, et al. Intravascular ultrasound assessment in carotid interventions. J Endovasc Surg. 1996;3:203–10.PubMedCrossRefGoogle Scholar
  18. 18.
    Diethrich EB, Marx P, Wrasper R, et al. Percutaneous techniques for endoluminal carotid interventions. J Endovasc Surg. 1996;3:182–201.PubMedCrossRefGoogle Scholar
  19. 19.
    Reid DB, Irshad K, Miller S, et al. Endovascular significance of the external carotid artery in the treatment of cerebrovascular insufficiency. J Endovasc Ther. 2004;11:727–33.PubMedCrossRefGoogle Scholar
  20. 20.
    Irshad K, Bain D, Miller PH. The role of intravascular ultrasound in carotid angioplasty and stenting. In: Henry M, editor. Angioplasty and stenting of the carotid and supra-aortic trunks. London: Martin Dunitz; 2004. p. 127–33.Google Scholar
  21. 21.
    Irshad K, Miller PH, McKendrick M, et al. The role of IVUS for stentgraft repair in TAA and TAD. In: Amor M, Bergeron P, editors. Thoracic aorta endografting. Marseille: Com & Co; 2004. p. 73–7.Google Scholar
  22. 22.
    Zamboni E, Galeotti R, Menegatti E, et al. A prospective open – label study of endovascular treatment of chronic cerebrospinal venous insufficiency. J Vasc Surg. 2009;50:1348–58.PubMedCrossRefGoogle Scholar
  23. 23.
    Arko F, Mattauer M, McCullugh R, et al. Use of intravascular ultrasound improves long-term clinical outcome in the endovascular management of atherosclerotic aorto iliac occlusive disease. J Vasc Surg. 1998;27:614–23.PubMedCrossRefGoogle Scholar
  24. 24.
    Dangas G, Laird JR, Mehran R. Intravascular ultrasound guided renal artery stenting. J Endovasc Ther. 2001;8:238–47.PubMedCrossRefGoogle Scholar
  25. 25.
    Reid AW, Reid DB, Roditi GH. Vascular imaging: an unparalleled decade. J Endovasc Ther. 2004;II(Suppl II):II163–79.Google Scholar
  26. 26.
    Diethrich EB, Irshad K, Reid DB. Virtual histology intravascular ultrasound in peripheral interventions. Semin Vasc Surg. 2006;19:155–62.PubMedCrossRefGoogle Scholar
  27. 27.
    Irshad K, Millar S, Velu R, et al. Virtual histology intravascular ultrasound in carotid interventions. J Endovasc Ther. 2007;14:198–207.PubMedCrossRefGoogle Scholar
  28. 28.
    Diethrich EB, Pauliina Margolis M, Reid DB. Virtual histology intravascular ultrasound assessment of carotid artery disease: the Carotid Artery Plaque Virtual Histology Evaluation (CAPITAL) study. J Endovasc Ther. 2007;14:676–86.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London 2013

Authors and Affiliations

  1. 1.Arizona Heart FoundationPhoenixUSA
  2. 2.Department of Vascular and Endovascular SurgeryWishaw HospitalScotlandUK

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