[Clinical usefulness of contrast-enhanced intracoronary ultrasound (ICUS) and evaluation of suitable contrast agents for ICUS].
It is sometimes difficult to visualize the luminal borders of the vessel even by intracoronary ultrasound (ICUS), especially after coronary intervention. In this study, we evaluated the potential for improving visualization at intervention sites using contrast-enhanced ICUS and the suitable contrast agents for this procedure in humans. In 37 patients, ICUS (30 MHz) was performed with intracoronary injection (3 ml) of 7 different contrast preparations and without the contrast agents (control) after coronary intervention. The contrast agents used were as follows: saline solution, standard iomeprol, standard ioxaglate, sonicated iomeprol, sonicated ioxaglate, 50% Albunex, and 100% Albunex. Vessel wall delineation, contrast homogeneity (Grade 0-3), peak contrast intensity and shadowing were examined. Homogeneous and complete opacification of the vessel lumen and false lumen was observed with sonicated ioxaglate, 50% and 100% Albunex. Shadowing was not observed at all with sonicated ioxaglate and was uncommon with 50% Albunex, whereas 100% Albunex caused shadowing in all cases. The coronary delineation rate with the other contrast agents was only 50-70 %, and the homogeneity and peak intensity were relatively low. Thus, sonicated ioxaglate and 50 % Albunex both achieved good visualization, but the former is cheaper, stable and takes shorter to prepare. Large dissection in 5 patients were found by contrast-enhanced ICUS' whereas they were not detected by coronary angiography. All of them needed additional interventional therapy due to the results of contrast-enhanced ICUS. In conclusion, contrast-enhanced ICUS is useful for evaluation of the results by intervention therapy, and of the agents we studied sonicated ioxaglate is best for contrast-enhanced ICUS.
Tanaka
K
K
Division of Cardiology, Osaka Rosai Hospital.
Nishino
M
M
Tanouchi
J
J
D000418:Albumins / Q000008:administration & dosage; D003287:Contrast Media / Q000008:administration & dosage*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007479:Iopamidol / Q000008:administration & dosage / Q000031:analogs & derivatives; D007485:Ioxaglic Acid / Q000008:administration & dosage; D008297:Male; D008863:Microspheres; D008875:Middle Aged; D012965:Sodium Chloride; D013010:Sonication; D018084:Ultrasonography, Interventional / Q000379:methods*
D000418:Albumins; C060687:Albunex; D003287:Contrast Media; C057937:iomeprol; D012965:Sodium Chloride; D007479:Iopamidol; D007485:Ioxaglic Acid