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IVUS Guidance

Abstract

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Positive remodeling at 3 year follow up is associated with plaque-free coronary wall segment at baseline: a serial IVUS study Clinical use of intracoronary imaging. Part 1: guidance and optimization of coronary interventions. An expert consensus document of the European Association of Percutaneous Cardiovascular Interventions: Endorsed by the Chinese Society of Cardiology Long-term health outcome and mortality evaluation after invasive coronary treatment using drug eluting stents with or without the IVUS guidance. Randomized control trial. HOME DES IVUS Clinical Outcomes Following Intravascular Imaging-Guided Versus Coronary Angiography-Guided Percutaneous Coronary Intervention With Stent Implantation: A Systematic Review and Bayesian Network Meta-Analysis of 31 Studies and 17,882 Patients Optical frequency domain imaging vs. intravascular ultrasound in percutaneous coronary intervention (OPINION trial): one-year angiographic and clinical results Role of Proximal Optimization Technique Guided by Intravascular Ultrasound on Stent Expansion, Stent Symmetry Index, and Side-Branch Hemodynamics in Patients With Coronary Bifurcation Lesions Subclinical Atherosclerosis Burden by 3D Ultrasound in Mid-Life: The PESA Study Meta-analysis of outcomes after intravascular ultrasound-guided versus angiography-guided drug-eluting stent implantation in 26,503 patients enrolled in three randomized trials and 14 observational studies
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Review Article2012 Mar;5(3 Suppl):S111-8.

JOURNAL：JACC Cardiovasc Imaging. Article Link

Plaque composition by intravascular ultrasound and distal embolization after percutaneous coronary intervention

Claessen BE, Maehara A, Fahy M et al. Keywords: distal embolization; percutaneous coronary intervention; virtual histology intravascular ultrasound

ABSTRACT

Distal embolization after percutaneous coronary intervention occurs in 15% to 70% of patients, depending on the sensitivity of the diagnostic modality used, and is associated with a poor prognosis after elective and primary percutaneous coronary intervention. It has been hypothesized that imaging of the plaque composition can identify coronary artery lesions that are predisposed to causing distal embolization. This review report aims to summarize all currently available published data on the use of assessment of atherosclerotic plaque composition by virtual histology intravascular ultrasound (VH-IVUS) to predict the occurrence of distal embolization. A systematic review of the literature was performed. We searched Medline, ISI Web of Knowledge, and the Cochrane Library from January 2002 until March 2011. When a study was found to be relevant, the manuscript was obtained and reviewed. A total of 11 studies were identified investigating the relationship between plaque composition assessed by VH-IVUS and distal embolization. Although all studies used the same equipment to perform and analyze VH-IVUS, there was considerable heterogeneity in patient characteristics, outcome definitions, and reporting of VH-IVUS findings. Nevertheless, the necrotic core plaque component-either by itself or as a constituent of a VH thin cap fibroatheroma-was associated with distal embolization in all but 2 of the 11 reviewed studies. Therefore, identification of lesions with large amounts of necrotic core on VH-IVUS could identify lesions that might benefit from the selective use of embolic protection devices.

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