title: Intracoronary ultrasound evaluation of interventional technologies.
abstract: The feasibility and applicability of intravascular ultrasound (IVUS) of the coronary arteries were evaluated in 65 patients undergoing 70 coronary interventional procedures. Morphologic and quantitative analyses were performed with a mechanically rotated IVUS catheter (4.8Fr, 20 MHz) and with orthogonal view cineangiography. A semiautomated edge-detection algorithm was used for cineangiographic quantification. Coronary interventions included 45 percutaneous transluminal coronary angioplasties, 9 excimer lasers, 11 directional coronary atherectomies, 3 rotational atherectomies and 2 stents. Most lesions consisted of a mixture of plaque composition (hard, n = 30; soft, n = 64). Other unique morphologic data by IVUS were plaque topography (eccentric, n = 34; concentric, n = 36) and vessel dissection (IVUS [n = 29] versus angiography [n = 14], p less than 0.05). Postprocedure minimal lumen diameter and cross-sectional area measured by IVUS were larger and poorly correlated with angiography (r = 0.28, standard error of the estimate = 0.52 mm; r = 0.08, standard error of the estimate = 1.0 cm2, respectively). IVUS is more sensitive than angiography when assessing postintervention lesion characteristics including vessel dissection and plaque morphology. Catheter-based ultrasound appears to be a useful adjunct to contrast angiography when evaluating and comparing the therapeutic impact of conventional percutaneous transluminal coronary angioplasty with new technologies.
authors.affiliation: Department of Medicine, Duke University Medical Center, Durham, North Carolina 27710.
authors.forename: C J
authors.initials: CJ
authors.lastname: Davidson
authors.forename: K H
authors.initials: KH
authors.lastname: Sheikh
authors.forename: K B
authors.initials: KB
authors.lastname: Kisslo
authors.forename: H R
authors.initials: HR
authors.lastname: Phillips
authors.forename: R H
authors.initials: RH
authors.lastname: Peter
authors.forename: V S
authors.initials: VS
authors.lastname: Behar
authors.forename: Y H
authors.initials: YH
authors.lastname: Kong
authors.forename: M
authors.initials: M
authors.lastname: Krucoff
authors.forename: E M
authors.initials: EM
authors.lastname: Ohman
authors.forename: J E
authors.initials: JE
authors.lastname: Tcheng
mesh_terms: D000465:Algorithms; D015906:Angioplasty, Balloon, Coronary; D016342:Angioplasty, Laser; D002932:Cineangiography; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D014463:Ultrasonography