See clearly.
Treat optimally.
Angiography alone is not enough in PCI
Angiography provides information on luminal characteristics of vessels, but does not provide a clear picture of the vessel and disease.
However, with IVUS guidance you can see more clearly and improve patient outcomes with informed pre-stent planning and post-stent optimization.1
74%
of the time, IVUS use resulted in a change in PCI strategy2,3,4,5
46%
Reduction in TVF at 1 year when IVUS was used6,7
43%
Lower risk of cardiac death associated with IVUS8
See clearly and treat optimally with IVUS in a variety of clinical scenarios
Left main
IVUS is an AHA/ACC/SCAI Class IIa recommendation for the assessment of angiographically indeterminant left main CAD.9
IVUS may help to determine:
• Lesion significance
• Vessel sizing
• Optimal stent deployment
Ostial and bifurcation lesions
IVUS guidance reduced long-term all-cause mortality by 76%.10
IVUS may help to determine:
• Location of the true ostium to decrease risk of geographic miss
• Plaque distribution
• Whether two stents are needed
• Lesion length
• Landing zones
• Whether post-dilation is needed (especially at the proximal stent)
Diffuse disease
Using IVUS for long lesions (stents ≥ 28mm) was associated with a 47% reduction in MACE from 1 to 5 years in the IVUS-XPL randomized control trial.11
IVUS may help to determine:
• Vessel size and length of disease
• Positive remodeling
• Plaque burden
• Stenosis
Repeat patients
IVUS is an AHA/ACC/SCAI Class IIa recommendation to determine the mechanism of stent restenosis.9IVUS may help to determine:
• Extent and mechanism of restenosis for optimal treatment strategy and for the decrease of risk of geographic miss
• Location and amount of thrombus
Ambiguous angiogram
IVUS guidance was associated with less contrast: 20 ml vs. 64.5 ml, p<.001, n=83 patients randomized to IVUS or angiographyguided PCI.12
IVUS may help to determine:
• Pathology at the ambiguous site to optimize your treatment strategy
• Device utilization without additional radiation and contrast
Left main
IVUS is an AHA/ACC/SCAI Class IIa recommendation for the assessment of angiographically indeterminant left main CAD.9 IVUS may help to determine: • Lesion significance • Vessel sizing • Optimal stent deployment
Ostial and bifurcation lesions
IVUS guidance reduced long-term all-cause mortality by 76%.10 IVUS may help to determine: • Location of the true ostium to decrease risk of geographic miss • Plaque distribution • Whether two stents are needed • Lesion length • Landing zones • Whether post-dilation is needed (especially at the proximal stent)
Diffuse disease
Using IVUS for long lesions (stents ≥ 28mm) was associated with a 47% reduction in MACE from 1 to 5 years in the IVUS-XPL randomized control trial.11 IVUS may help to determine: • Vessel size and length of disease • Positive remodeling • Plaque burden • Stenosis
Repeat patients
IVUS may help to determine: • Extent and mechanism of restenosis for optimal treatment strategy and for the decrease of risk of geographic miss • Location and amount of thrombus
IVUS is an AHA/ACC/SCAI Class IIa recommendation to determine the mechanism of stent restenosis.9
Ambiguous angiogram
IVUS guidance was associated with less contrast: 20 ml vs. 64.5 ml, p<.001, n=83 patients randomized to IVUS or angiographyguided PCI.12 IVUS may help to determine: • Pathology at the ambiguous site to optimize your treatment strategy • Device utilization without additional radiation and contrast
IVUS interpretation insights
IVUS imaging helps you visualize the best path forward. Dive deeper to understand how IVUS imaging works and how to easily interpret vessel morphologies in common clinical scenarios.
Interventional excellence
Imaging, physiology, co-registration* and software come together to simplify complex interventions, speed routine procedures and provide improved patient care.
Get advanced insight from your pullback
Experience the advanced imaging insights from Philips ChromaFlo and IVUS Co-registration and improve your treatment strategies.
Coronary IVUS catheters
Become an IVUS expert
Advance your IVUS imaging skills with interactive workflows and detailed image interpretation practice. The Philips Coronary IVUS Tutor app is free to download in the App Store or Google Play.
Practice using IVUS in cases
Experience the interactive educational app CardioEx which now features new cases on Philips IVUS, physiology and co-registration. Cardio Ex app is free to download in the App Store or Google Play.
Philips ELIITE Academy is focused on delivering high value and real-time strategic educational programs that meet the evolving needs of our customers. For more information on the available courses, please visit www.igtdacademy.philips.com.
Key thought leaders
Clinical expertise
Product knowledge
Reimbursement and coding resources
* Co-registration tools available within IntraSight 7 configuration via SyncVision 1. A. Maehara, M. Matsumura, Z.A. Ali, G.S. Mintz, G.W. Stone. IVUS-guided versus OCT-guided coronary stent implantation. J Am Coll Cardiol Img, 10 (2017), pp. 1487- 1503 2. Elgendy IY et al. Outcomes with intravascular ultrasound-guided stent implantation: a meta-analysis of randomized trials in the era of drug eluting stents. Circ-Cardiovasc Interv.2016;9:e003700 3. Ahn JM, Kang SJ, Yoon SH, et al. Meta-analysis of outcomes after intravascular ultrasound-guided versus angiography-guided drug-eluting stent implantation in 26,503 patients enrolled in three randomized trials and 14 observational studies. Am J Cardiol. 2014;113:1338-1347. Hyperlink “https://www.ajconline.org/article/S0002-9149(14)00549-9/abstract” 4. Witzenbichler B, et al. Relationship between intravascular ultrasound guidance and clinical outcomes after drug-eluting stents: The ADAPT-DES study. Circulation. 2014 Jan:129,4;463-470. 5. Singh V, Badheka AO, Arora S, et al. Comparison of in-hospital mortality, length of hospitalization, costs, and vascular complications of percutaneous coronary interventions guided by ultrasound versus guided by angiography. Am J Cardiol. Online 18 Feb 2015. 6. TVF categorized as cardiac death, target vessel MI, and clinical driven TVR 7. Zhang J et al. The ULTIMATE trial. Journal of the American College of Cardiology (2018), doi.org/10.1016/j.jacc.2018.09.013. , accepted September 13 2018. 8. Choi K, et al. Impact of Intravascular Ultrasound-Guided Percutaneous Coronary Intervention on Long-Term Clinical Outcomes in Patients Undergoing Complex Procedures. JACC: Cardivascular Interventions. Mar 2019, 4281; DOI: 10.1016/j.jcin.2019.01.227 9. Levine et al. 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. Circulation 2011;124:e574-651] 10. Kim S, Kim Y, et al. Long-term outcomes of intravascular ultrasound-guided stenting in coronary bifurcation lesions. Am J Cardiol. 2010;106(5):612-8] 11. Hong S-J, et al. “Effect of Intravascular Ultrasound-guided Drug-Eluting Stent Implantation: Five-Year Follow-Up of the IVUS-XPL Randomized Trial, JACC: Cardiovascular Interventions (2019), doi: https://doi.org/10.1016/j.jcin.2019.09.033 12. Mariani et al. MOZART study. JACC Interventions 2014; 7:1287-93.
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