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Intravascular Ultrasound and Other Intravascular Imaging Techniques

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Questions or comments about Intravascular Ultrasound (IVUS) or other intravascular imaging techniques like optical coherence tomography (OCT) etc.

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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

Cyril, Europe, December 26, 2008





























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