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IVUS Guidance

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Angiographic and clinical comparisons of intravascular ultrasound- versus angiography-guided drug-eluting stent implantation for patients with chronic total occlusion lesions: two-year results from a randomised AIR-CTO study Three-Year Outcomes of the ULTIMATE Trial Comparing Intravascular Ultrasound Versus Angiography-Guided Drug-Eluting Stent Implantation Clinical impact of PCSK9 inhibitor on stabilization and regression of lipid-rich coronary plaques: a near-infrared spectroscopy study 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 Role of intravascular ultrasound in patients with acute myocardial infarction undergoing percutaneous coronary intervention Subclinical Atherosclerosis Burden by 3D Ultrasound in Mid-Life: The PESA Study Tissue characterisation of atherosclerotic plaque in the left main: an in vivo intravascular ultrasound radiofrequency data analysis Impact of intravascular ultrasound on the long-term clinical outcomes in the treatment of coronary ostial lesions Utility of intravascular ultrasound guidance in patients undergoing percutaneous coronary intervention for type C lesions A Randomized Study of Distal Filter Protection Versus Conventional Treatment During Percutaneous Coronary Intervention in Patients With Attenuated Plaque Identified by Intravascular Ultrasound
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Review Article2015;11 Suppl V:V55-8.

JOURNAL：EuroIntervention. Article Link

IVUS in bifurcation stenting: what have we learned?

Legutko J, Yamawaki M, Costa RA et al. Keywords: intravascular ultrasound; stents; imaging; left main coronary artery; coronary bifurcation lesions

ABSTRACT

Coronary angiography is unable to visualise the atherosclerotic involvement of the arterial wall. Bifurcation lesions are particularly difficult to assess by angiography because overlapping mother and daughter vessels often obscure the lesion and carina. On the contrary, IVUS imaging allows for precise, real-time, cross-sectional assessment of all bifurcation lesion segments, enabling measurements of luminal and vessel areas. Moreover, IVUS evaluation of stent expansion, apposition and edge problems is also superior to angiographic assessment. In spite of the lack of adequately powered randomised trials, there is growing evidence from large registries and meta-analyses showing better acute and long-term outcomes of DES implantation guided by IVUS, in comparison to angiography-guided procedures. In this review, we summarise current scientific evidence, the European Society of Cardiology recommendations and the European Bifurcation Club consensus for the use of IVUS in bifurcation stenting.

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