Intracoronary ultrasound imaging: methods and clinical applications

OBJECTIVE: To review the development of intracoronary ultrasound, its current utility and the impetus for its continued development as a coronary imaging modality. DATA SOURCES: English-language literature (1966 to 1999) was searched in the MEDLINE database with the key words 'ultra- sound', 'intravascular' and 'intracoronary', and limited to human studies. In addition, an online public access catalogue was searched using the subject headings 'cardiovascular diseases - therapy', 'heart diseases' and 'vascular diseases'. STUDY SELECTION AND DATA EXTRACTION: Articles relating to the history of intravascular or intracoronary ultrasound, methods and materials employed, advantages and disadvantages, safety issues and future directions of research in the area of intracoronary ultrasound were selected. DATA SYNTHESIS: Intracoronary ultrasound has been shown to improve upon demonstrated weaknesses of coronary angiography. This imaging technique, while invasive, has not been associated with significant, acute adverse effects and has proved to be useful in guiding interventions, and evaluating the mechanism and extent of their success. Technological limitations with respect to the equipment employed, and the acquisition, processing and display of images are the subject of intense research focus because they hinder more widespread clinical use of intracoronary ultrasound. CONCLUSIONS: Intracoronary ultrasound has emerged as a safe and useful tool in the visualization of the coronary vasculature. Technological limitations and questions about long term safety are a concern. Its ability to overcome the inherent limitations of coronary angiography, and to guide and evaluate coronary interventions supports the notion that this technique will continue to assume an ever-expanding role in interventional cardiology.