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

left main bubble

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)

ambiguous angio gram bubble

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

diffuse disease bubble

Repeat patients


IVUS is an AHA/ACC/SCAI Class IIa recommendation to determine the mechanism of stent restenosis.

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 angio gram bubble

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

ambiguous angio gram bubble