Feasibility of intravascular ultrasound studies: Predictors of imaging success before coronary interventions

Abstract

SummaryBackground: Intravascular ultrasound (IVUS) is currently used to study lesions during transcatheter coronary therapy. However, before dilation some lesions cannot be reached or crossed with the imaging catheter.Hypothesis: This study seeks to elucidate which factors determine the feasibility of IVUS examination before coronary interventions.Methods: Accordingly, 100 consecutive patients undergoing IVUS examination before coronary angioplasty were prospectively studied. The clinical and angiographic characteristics of 77 patients with a successful IVUS study (Group A) were compared with those of 23 patients in whom NUS was attempted but the target lesion could not be interrogated (Group B). The echogenic characteristics of the target lesion [before (n = 77) or after intervention (in 18 patients in Group B)] were also studied.Results: Patients in Group B were significantly older (62 k

Clinical and Angiographic Predictors and Prognostic Value of Failed Thrombus Aspiration in Primary Percutaneous Coronary Intervention

“…In the current study, predictors of failure of TA were generally lesionspecific rather than patient-dependent. Previously, the presence of marked tortuosity and coronary calcification have been identified to be predictors of failure of intravascular ultrasound imaging, at a rate of 23% failed procedures described in a prospective cohort of patients with stable or unstable angina (16). The difference in flexibility of the catheters used for intravascular ultrasound with those currently used for TA and the dissimilar patient characteristics may explain the lower failure rate we observed.…”

Pressure wire kinking, entanglement, and entrapment during intravascular ultrasound studies: A potentially dangerous complication

“…Although the guidewire tends to straighten the proximal curves of instrumentalized vessels, the distal advancement of these catheters and their capability to negotiate tortuous vessels remains restricted. In a previous study [11], we found that catheter size, baseline minimal lumen diameter, proximal tortuosities, and lesion calcification were independent predictors of failure to cross the target lesion. If too much force is inadvertently applied to advance the IVUS catheter, displacement of the catheter, away from the guidewire, could be induced [11], and then the guidewire may be kinked and caught within the imaging system.…”

“…Nowadays, IVUS imaging is a user-friendly technique widely used during coronary interventions [1,2]. In our experience [11], the presence of tortuous proximal coronary segments hampers catheter manipulation and advancement across the target lesion. Although the guidewire tends to straighten the proximal curves of instrumentalized vessels, the distal advancement of these catheters and their capability to negotiate tortuous vessels remains restricted.…”

Quantitative measurements of in-stent restenosis: A comparison between quantitative coronary ultrasound and quantitative coronary angiography

“…However, there is a growing interest in applying intracoronary ultrasound (ICUS) as an additional imaging tool since quantitative coronary ultrasound (QCU) allows the evaluation of not only the lumen (QCA) but also the vessel wall [9][10][11][12][13][14][15][16]. This is of particular interest in restenosis or progression-regression studies [17].…”