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Intravascular ultrasound
Definition
Intravascular ultrasound is a test that uses sound waves to see inside the coronary arteries, the blood vessels that supply the heart.Alternative Names
IVUS; Ultrasound - coronary artery; Endovascular ultrasoundDescription
Ultrasound uses sound waves to create moving images of organs and systems within the body. IVUS is a combination of a heart ultrasound (echocardiogram) and cardiac cathertization.
A tiny ultrasound wand is attached to the top of a tiny, hollow tube called a catheter. During the IVUS procedure, the ultrasound catheter is inserted into an artery in your groin area and moved up to the heart. This gives the health care provider a look at your arteries from the inside-out.
IVUS is often done during angioplasty. Angioplasty gives a general look at the coronary arteries, but can not show the walls of the arteries. IVUS images highlight the artery walls and can show if there are cholesterol and fat deposits (plaques). Build up of such plaque leads to hardening of the arteries (atherosclerosis).
IVUS has provided a great amount of insight into how stents become clogged (stent restenosis). The method has helped show that about 20% of cases of stent restenosis occur when the stent has not expanded properly.
Why the Procedure is Performed
IVUS may be used to:
- View the aorta and structure of the artery walls (which can show plaque build up)
- Identify which specific blood vessel is involved in aortic dissection
- Determine where a stent should be placed
- Discover how well angioplasty and stenting worked
Risks
There is a slight risk of complications associated with angioplasty and cardiac catheterization. However, the tests are very safe when performed by an experienced team. IVUS adds no additional risk.
Risks of angioplasty may include:
- Allergic reaction to any dye used during the test
- Complete blockage of blood flow in a certain area
- Damage to a blood vessel
- Heart arrhythmias
- Hemorrhage (bleeding) in area where the catheter was inserted
- Stroke
Risks of cardiac catheterization may include:
- Allergic reaction to any dye used during the test
- Cardiac tamponade
- Heart arrhythmias
- Heart attack
- Hemorrhage (bleeding)
- Injury to the artery caused by a hematoma
- Low blood pressure
- Stroke
Outlook (Prognosis)
After the test, the catheter is removed. A bandage is placed on the area. You will usually be asked to lie flat on your back with pressure on your groin area for a few hours after the test to prevent bleeding.
If IVUS was done during cardiac catheterization, you will stay in the hospital for about 3 to 6 hours. If IVUS was done during angioplasty, you will stay in the hospital for 12 to 24 hours.
References
Hartnell GG, Gates J. Ischaemic heart disease. In: Grainger RC, Allison D, Adam, Dixon AK, eds. Diagnostic Radiology: A Textbook of Medical Imaging. 5th ed. New York, NY: Churchill Livingstone; 2008:chap 25.
Nicholson T, Patel J. The aorta, including intervention. In: Grainger RC, Allison D, Adam, Dixon AK, eds. Diagnostic Radiology: A Textbook of Medical Imaging. 5th ed. New York, NY: Churchill Livingstone; 2008:chap 27.
Sipahi I. Intravascular Ultrasound in the Current Percutaneous Coronary Intervention Era. Cardiol Clin. 2006 May; 24(2); 163-173.
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; and Emile Riggs Mohler III, MD, Vascular Medicine, Associate Professor of Medicine, Department of Medicine, University of Pennsylvania School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
