Application of Intravascular Ultrasound During Percutaneous Coronary Interventions in Controversial Cases and Complex Atherosclerotic Lesions

Abstract

The aim of the study is to present our own experience of using intravascular ultrasound (IVUS) for making a clinically informed decision to perform percutaneous coronary intervention (PCI) in a particular patient. Material and methods: A 65-year-old patient with angina pectoris and a positive exercise test, which revealed horizontal ST depression in the chest leads, underwent diagnostic coronary angiography, which diagnosed stenosis of up to 50 % of the trunk of the left coronary artery (LCA). In this connection, IVUS was performed to make a decision on the advisability of performing PCI. According to IVUS data, the area of narrowing of the LCA trunk was 60 %. There is a “torn” edge of the intima of the vessel with severe calcification in the largest segment of the narrowing, which indicates the “instability” of the atherosclerotic plaque. The patient underwent PCI with stenting of the LCA trunk with a transition to the proximal segment of the anterior descending artery (LAD) due to the spread of an atherosclerotic plaque at the mouth of the LAD. Conclusion: IVUS plays an important role in the decision to perform PCI in controversial cases and complex atherosclerotic lesions.