Intravascular Ultrasound: A Review of Radial and Side Firing IVUS

Intravascular ultrasound (IVUS) has become an essential tool for endovascular procedures, particularly during complex interventions. The benefits include improved visualization of vascular and extravascular anatomy, reduced complication rates, and enhanced accuracy during catheter-based interventions. In this review, we discuss the properties of side-firing (also commonly known as intracardiac echo ICE) and radial IVUS and explore their unique applications in endovascular procedures. The side-firing IVUS is advantageous for visualizing lesions and vascular structures in a plane parallel to the vessel wall, making it effective for guiding portal venous interventions, transvenous biopsies, and endoleak embolization, while the radial IVUS provides a 360-degree view of the vessel lumen, enabling detailed cross-sectional images of normal anatomy, pathologic processes requiring different endovascular therapy and their response to intervention(s).