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
Left main
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 52% reduction in
MACE at 1 year 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.9
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
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
