Intravascular Ultrasound Imaging: Use in Peripheral Laser-Assisted Angioplasty

The proliferation of sophisticated endovascular interventions is mandating more definitive and comprehensive documentation of atherosclerotic lesions and the results of the interventional devices used in their removal. A technique with a potential to fulfill these goals, intravascular ultrasound imaging (IVUS), was evaluated against pressure gradients, arteriography, and femoral-radial indices in 11 patients with stenotic iliac lesions. The two-dimensional, real-time scans were useful in measuring pre-and posttreatment cross-sectional diameters and luminal areas for procedural assessment. Furthermore, the ultrasound scans clearly identified arterial wall calcifications, iliac veins, soft plague formations, dissections, synthetic graft anastomoses, and intravascular stents, often with definition superior to arteriography. The IVUS technique was useful in selecting interventional therapies, in particular, the need for stent implantation to control intimal flaps. Further, IVUS demonstrated its ability as a substitute for contrast arteriography in a twelfth patient with an iliac stent in whom a protocol-dictated follow-up arteriogram was contraindicated.