[Intravascular ultrasound imaging as adjunct to vascular interventions: preliminary experience in patients with atherosclerotic disease].

Catheter-based intravascular ultrasound (IVUS) imaging is new, evolving technique in which a high-frequency transducer is attached to the tip of a catheter. In this study, we evaluated the usefulness of catheter-based IVUS in 11 patients with atherosclerotic disease as an adjunct to PTA or atherectomy. A 30-MHz ultrasound catheter was inserted through a 6 F sheath to obtain real-time and cross-sectional images. The IVUS images demonstrated a three-layered appearance of muscular arteries, intimal thickening and calcification. IVUS was performed in 11 patients undergoing percutaneous transluminal angioplasty (7 patients) or atherectomy (4 patients). The presence of dissection between the media and atheroma was observed after balloon angioplasty, while IVUS imaging demonstrated a smooth wall after atherectomy. There was a good correlation between IVUS and angiography in the quantitative assessment of luminal %diameter stenosis before vascular intervention, but a poor correlation was observed after angioplasty, probably due to the dissections from balloon dilatation that resulted in irregular crescentic pathways with unclear borders to the lumen on angiography. The results of our study illustrate the potential utility of IVUS as an adjunct to transluminal vascular intervention.