Use of intravascular ultrasound improves long-term clinical outcome in the endovascular management of atherosclerotic aortoiliac occlusive disease

Abstract

The use of IVUS may be the best means for assessing adequacy of arterial stent deployment. Our study suggests that the use of IVUS improves the long-term clinical outcome of balloon angioplasty and stented aortoiliac occlusive lesions.

Intravascular ultrasound in interventional radiology

“…In a group of 36 non-consecutive aortoiliac procedures 40 % of the patients had underdeployed stents by IVUS evaluation, although they appeared adequately expanded by arteriography (see Fig. 3) [35]. Among 18 A Coronary angiography shows a hemodynamically significant stenosis at the proximal left circumflex artery (LCX) (arrow).…”

“…Several studies have shown that angiography frequently overestimates lumen dimensions after stent placement, and the stent may be inadequately expanded even after high-pressure dilatation [34,35,36]. In an analysis composed of iliac, femoral, and subclavian artery stents IVUS imaging revealed discrepancy between stent deployment and balloon size used, so that the smallest intrastent lumen area was on average 32 % smaller than the balloon size used [36].…”

A lumen sizing workhorse guidewire for peripheral vasculature: Two functions in one device

“…Angiographic visual assessment is the standard clinical practice for lower extremity peripheral vasculature (PV) dimension determination prior to percutaneous transluminal angioplasty (PTA). Visual and automated angiographic luminal assessment, however, regularly size dimension incorrectly which can lead to less optimal PTA and diminished clinical outcomes (increased restenosis rates, dissection, perforation, or acute vessel closure) . Other imaging modalities like, computed tomography (CT), magnetic resonance imaging (MRI), and intravascular ultrasound (IVUS) provide a more accurate dimensional image to improve vessel patency post‐stent deployment compared to angiographic visual assessment alone .…”

Conductance sizing balloon for measurement of peripheral artery minimal stent area

“…1,2 Stent underdeployment, defined as failure to have full strut apposition, occurs in 40% of percutaneous peripheral interventions. 3,4 There are even higher reported rates (70%-85%) during percutaneous coronary intervention when a more comprehensive definition of underdeployment, defined as expansion <90% of the expected minimal stent diameter or failure to have full strut apposition with <80% to 90% of the expected minimal stent area (MSA), is used. [5][6][7][8] The inability to achieve adequate deployment with full stent apposition impacts in-stent restenosis rates, in-stent thrombosis formation, and target vessel revascularization rates.…”