ISSN: 1305-385X
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Intravascular Ultrasonography
Dr. M. Taner GÖRENa
aKardiyoloji AD, İstanbul Üniversitesi İstanbul Tıp Fakültesi, İSTANBUL
Coronary angiography is the most important diagnostic tool in the coronary artery disease; however, it can not give the information about vessel wall. Whereas, the atherosclerotic alterations in the vessel wall are critical in the mechanism of acute coronary syndrome. Intravascular ultrasonography (IVUS) was introduced into the cardiovascular medicine as an important method that provide vessel wall imaging. As a result of IVUS related studies, the concepts such as vulnerable plaque and positive remodeling were clarified.
IVUS is performed with a catheter incorporating miniaturized transducer; 20-50 mHZ ultrasound frequencies are used. There are two types IVUS catheter: Mechanical and electronic catheters. The diameter of today’s IVUS catheters is less than 3F. These catheters can be advanced to the distal coronary arteries; after advancing, the catheter is withdrew at a constant speed. The image data obtaining via IVUS cateheter are reconstructed by the IVUS machine and the cross-sectional tomographic vessel wall images are obtained. Three layer are differentiated in the coronary artery wall by IVUS images: Intima, media and adventitia.
Although image quality became fairly good, the vulnerable plaques can not be differentiated by IVUS sufficiently yet; because of this, IVUS is not used rutinely. Today, IVUS is used for assessment of ambiguous coronary stenoses, ostial and bifurcation lesions; IVUS is used before and after balon angioplasty and coronary stenting in the complex cases to choose suitable balon and stent, and to assess results. IVUS is also used in the atheroma regression studies.Keywords: Intravascular ultrasonographyTurkiye Klinikleri J Int Med Sci 2005, 1(42):13-18
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