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Intravascular Ultrasound Use in Peripheral Arterial and Deep Venous Interventions: Multidisciplinary Expert Opinion

Eric A Secemsky1,2, Herbert D Aronow3,4, Christopher J Kwolek2,5

  • 1Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology and Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts.

Journal of the Society for Cardiovascular Angiography & Interventions
|August 12, 2024
PubMed

Insights

Intravascular ultrasound (IVUS) offers superior imaging for lower extremity vascular disease compared to angiography. Standardizing its use can enhance outcomes in peripheral revascularization procedures.

Area of Science:

  • Vascular Medicine
  • Medical Imaging
  • Interventional Cardiology

Background:

  • Percutaneous revascularization is standard for lower extremity venous and arterial disease.
  • Angiography has limitations in accurately assessing vessel parameters and lesion characteristics.
  • Intravascular ultrasound (IVUS) overcomes these limitations, showing promise in peripheral interventions.

Purpose of the Study:

  • To assess the current state of lower extremity revascularization.
  • To identify knowledge gaps and evidence needs for peripheral IVUS.
  • To determine how IVUS can improve patient care and outcomes in peripheral arterial and deep venous disease.

Main Methods:

  • Consensus perspectives from a roundtable discussion.
  • Involved 15 physicians from interventional cardiology, interventional radiology, and vascular surgery.
  • Representing 6 cardiovascular specialty societies.

Main Results:

  • Angiography's limitations in vessel sizing, stenosis assessment, lesion characterization, and complication diagnosis.
  • IVUS demonstrates ability to improve outcomes in percutaneous coronary intervention.
  • Growing evidence supports IVUS benefits in peripheral vascular intervention.

Conclusions:

  • There is a need to standardize peripheral vascular IVUS imaging use and approach.
  • IVUS can significantly improve the diagnosis and treatment of peripheral arterial and deep venous pathology.
  • Further evidence and standardized protocols are needed to optimize IVUS application in lower extremity revascularization.

Keywords:
expert opinionintravascular imagingperipheral vascular disease

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