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Current Postings on This Page (4):
Abby - It sounds like your cardiologist was concerned that the angiogram didn't tell the whole story and he utilized intravascular ultrasound or IVUS to get a more accurate picture of your blockage. You can read more about this in our article on Intravascular Ultrasound (IVUS). Our guess is that you had a positive stress test, indicating ischemia and reduced blood flow. But the angiogram showed that the blockage was not "significant." IVUS looks at the blockage from inside the artery and is able to see the actual "native" wall, so a very accurate measurement of the blockage is possible. The angiogram is literally a shadow picture and is not always accurate, which is why IVUS and FFR technologies are used. Sometimes they show that what looks like a problem blockage is not, and it can safely be treated with medications. Sometimes, and we're assuming this is your case, it shows the opposite. In terms of "dealing with the stent for the rest of your life," hopefully the stent will continue doing its job and, once your course of antiplatelet medications is done, you won't have to deal with anything - just do what you can to lower your risk factors to slow or prevent the progress of coronary artery disease. Angioplasty.Org Staff, Angioplasty.Org, February 10, 2015
I recently had a nuclear medicine stress test and later had an angiogram done. The angiogram showed that I had a 50% block in my LAD. The cardio doc decided to do an ultrasound and based on what he saw, he decided that the blockage was not 50% but 80% and so he placed a stent. I am confused if the angiogram showed 50% block, why did he just not let me go with some medication. Now I have to deal with the stent for the rest of my life. Abby, Fort Worth, Texas, USA, January 31, 2015
Cyril -- IVUS is used in many of the major cath
labs around the world. If you'll check out our IVUS
Center, you'll see an interview with Dr. Antonio Colombo of Milan,
arguably one of the great proponents of IVUS technology. Also in Rotterdam
at the ThoraxCentre, Dr. Patrick Serruys and his team have done major research
using IVUS. But there are many labs using this imaging modality. If you'll
give us a narrower locus, we'll try to name hospitals, but you can also
call the major heart hospitals in your area. Ask for the cath lab and
put your question to them. From my own experience, I can relate that last
year a friend of mine had a heart attack and was taken to a cath lab I
did not know anyone at. When I heard that they used IVUS routinely (and
they used it on my friend) I was encouraged, because cardiologists who
use IVUS tend to be on the cutting edge, so to speak.
On a side note, part
of the challenge is that IVUS is not reimbursed by insurance everywhere. It
is in Japan, for example, and Japan is a big market for IVUS. A very large
percentage of interventional cases in Japan use IVUS. And interestingly,
in all the recent major stent trials, the Japanese arm tended to have much
better outcomes. We asked Dr. Shigeru Saito who was the principal Japanese
investigator for
both the Medtronic and Abbott stent trials why his results were better
and he said simly, "IVUS". Angioplasty.Org Staff, Angioplasty.Org, December 26, 2008
CAN YOU ADVISE ME IF IVUS IS AVAILABLE
IN EUROPE, IF SO WHERE? Cyril, Europe, December 26, 2008