title: Is there still a role for intravascular ultrasound in the current practice era?
abstract: Although coronary angiogram is considered the gold standard for coronary assessment, it consistently underestimates vessel size/lesion severity, and usually misses heavy calcified plaques. Intravascular ultrasound (IVUS) technology accurately determines vessel size/lesion severity and allows a detailed plaque composition evaluation. The role of IVUS guidance after bare metal stent implantation has been explored in various trials; however, no study has tested how the pre-procedural use of IVUS might impact intervention strategy and clinical outcome. Limited studies have specifically addressed the utility of IVUS after drug-eluting stent implantation. Based on the published evidence and on our clinical experience, we support a more liberal use of IVUS, especially when approaching complex coronary lesions, and resulting in an optimal interventional result that might impact clinical outcome.
authors.affiliation: Department of Internal Medicine, Division of Cardiology, Washington Hospital Center, Washington, DC, USA.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Maluenda
authors.forename: Augusto D
authors.initials: AD
authors.lastname: Pichard
authors.forename: Ron
authors.initials: R
authors.lastname: Waksman
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000628:therapy; D003937:Diagnosis, Differential; D006801:Humans; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D015607:Stents; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional