[Applications and value of intravascular ultrasound imaging in coronary interventions]

Intravascular ultrasound (IVUS) is a twodimensional imaging technique that provides crossections of the coronary artery with a high spatial resolution and therefore became the new gold standard for quantifying complex lesions. The detailed information about vessel and lumen dimensions before and particularly after angioplasty is of high clinical value, because the acute luminal gain is an important predictor of restenosis. At the moment IVUS is the only way of analyzing the plaque composition in vivo. This allows plaque-specific interventional therapy of coronary lesions with balloon or modern alternative angioplasty techniques like directional atherectomy, rotational atherectomy, stenting or a combination of these. IVUS can also quantify the plaque burden in angiographically normal reference segments during balloon angioplasty and stenting. This often leads to the use of larger balloon diameters than those chosen by angiographic measurement of the reference segments. For stenting the prognostic significance of this additional luminal gain could be shown, for other interventional procedures this is currently being investigated in controlled studies.