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Intravascular ultrasound for endovascular precision in pediatrics
John J Weaver1, David S Shin1, Jeffrey Forris Beecham Chick1,2
1Section of Vascular and Interventional Radiology, Department of Radiology, University of Washington, Seattle, WA, USA.
Insights
Intravascular ultrasound (IVUS) is a safe and valuable tool for pediatric interventional radiology (IR). It aids in reducing fluoroscopy time and contrast volume, making it essential for specific pediatric procedures.
Area of Science:
- Medical Imaging
- Interventional Radiology
- Pediatric Medicine
Background:
- Intravascular ultrasound (IVUS) is an established diagnostic and interventional tool, with guidelines for its use in percutaneous coronary intervention.
- IVUS adoption is growing in interventional radiology (IR), but consensus guidelines for its utilization are lacking.
- IVUS use in pediatric IR is limited due to unfamiliarity and concerns about pediatric anatomy compatibility.
Purpose of the Study:
- To provide an overview of rotational and phased-array IVUS types.
- To discuss common applications of IVUS in pediatric interventional procedures.
- To highlight the safety and utility of IVUS in pediatric IR.
Main Methods:
- Review of rotational and phased-array intravascular ultrasound technologies.
- Discussion of IVUS applications across various pediatric interventional procedure categories.
- Analysis of safety profile and benefits in pediatric patients.
Main Results:
- IVUS is a safe and effective tool for pediatric interventions in select patients.
- IVUS can significantly reduce fluoroscopy time and contrast agent volume.
- The article details common IVUS applications in pediatric IR.
Conclusions:
- Intravascular ultrasound is a valuable, albeit underutilized, tool in pediatric interventional radiology.
- Appropriate patient selection and understanding of techniques enable safe and effective IVUS use in pediatric interventions.
- IVUS offers significant benefits in pediatric practice by minimizing radiation exposure and contrast load.
Abstract:
Intravascular ultrasound (IVUS) is used as a diagnostic adjunct to angiography and has become a valuable diagnostic and interventional tool with a well-documented safety profile. The American College of Cardiology and the European Society of Cardiology have published guidelines regarding the use of IVUS in the setting of percutaneous coronary intervention. IVUS has gained popularity in the interventional radiology (IR) community in recent years; however, there are no consensus guidelines for utilization. Furthermore, IVUS remains an infrequently used modality in pediatric IR, likely because of unfamiliarity with the equipment and techniques, as well as concerns over the compatibility of these instruments with pediatric anatomy. IVUS can be safely used as a helpful and sometimes necessary tool for pediatric interventions in appropriately selected patients. The utility of IVUS for reducing both fluoroscopy time and contrast agent volume makes it particularly valuable in pediatric practice. This article presents an overview of both the rotational and phased-array IVUS types and an in-depth discussion on the most common applications of these techniques in the pediatric setting across multiple procedure categories.
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