ORIGINAL ARTICLES  VASCULAR AND ENDOVASCULAR PAPERS 

The Journal of Cardiovascular Surgery 2001 February;42(1):69-75

Copyright © 2009 EDIZIONI MINERVA MEDICA

lingua: Inglese

Intravascular ultrasound for iliac artery imaging. Clinical review

Vogt K. G., Schroeder T. V.

From the Department of Vascular Surgery Rigshospitalet, University of Copenhagen, Denmark

­IVUS is ­able to pro­duce trans-­sec­tion­al imag­es of the ­iliac arter­ies at a ­high res­o­lu­tion. The ­three ­layered appear­ance of the arte­ri­al ­wall can be vis­u­al­ized. In the ath­e­ros­cle­rot­ic dis­eased ­artery cal­ci­fied ­plaques can be dis­cerned ­from non-cal­ci­fied ­plaques, and the dis­tri­bu­tion of the ­plaque—eccen­tric or con­cen­tric—can be deter­mined. ­IVUS ­seems to be super­i­or to arter­i­og­ra­phy in quan­ti­fy­ing the ­degree of sten­o­sis, ­being ­able to ­relate the lumi­nal ­area to the med­i­a­bound­ed ­area at the ­same ­site of the ­artery. The dis­crep­an­cy ­between ­IVUS and arter­i­og­ra­phy is ­even great­er ­when eval­u­at­ing resid­u­al­sten­o­sis ­after PTA. Structures ­such as rup­ture, inti­mal ­flaps and dis­sec­tion are bet­ter vis­u­al­ized ­with ­IVUS. In ste­not­ic ­iliac arter­ies ­IVUS has ­been ­able to eval­u­ate the ­effect of PTA and stent­ing and relat­ing the ­effect to the mor­phol­o­gy of the ­plaque. ­IVUS meas­ure­ments ­seem to be impor­tant pre­dic­tors of the paten­cy of ­iliac PTA. The abil­ity of ­IVUS to eval­u­ate the adap­ta­tion of ­stents to the arte­ri­al ­wall ­makes it par­tic­u­lar­ly suit­ed as a con­trol pro­ce­dure for the deploy­ment of endo­vas­cu­lar stent­ed ­grafts. Finally ­IVUS has the abil­ity to dis­close insuf­fi­cien­cy of endar­te­rec­o­my, by vis­u­al­iz­ing remain­ing intra­lu­mi­nal mate­ri­al.