Utility of intravascular ultrasound in carotid stenting.
OBJECTIVE
To illustrate the utility of intravascular ultrasound (IVUS) imaging during endoluminal interventions in the carotid artery.


RESULTS
A patient with symptomatic internal carotid artery occlusive disease was treated with balloon angioplasty and evaluated with both angiography (interpreted as a widely patent outcome) and IVUS, which identified a residual 70% cross-sectional area stenosis. A stent was placed across the lesion, producing a 70% increase in the lumen as documented by IVUS in comparison to the cross-sectional area of the reference vessel. Postprocedural angiography of the stented segment showed only an approximate 20% increase in diameter.


CONCLUSIONS
This study highlights the utility of IVUS for accurate assessment of angioplasty outcome and for quantitative assessment of luminal volume following intervention and stent placement. The case emphasizes the need for IVUS as an integral part of the procedure to ensure adequate treatment and to accurately document the residual lesion for assessment of recurrence phenomena at follow-up.
Wilson
E P
EP
Division of Vascular Surgery, Harbor-UCLA Medical Center, Torrance 90509-9823, USA.
White
R A
RA
Kopchok
G E
GE
D000800:Angioplasty, Balloon; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D002533:Cerebral Angiography; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D015607:Stents; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional; D014654:Vascular Patency