Intravascular Ultrasound Assessment in Carotid Interventions

Abstract

Purpose: To demonstrate the clinical value of intravascular ultrasound (IVUS) imaging in monitoring stent deployment in the cervical carotid arteries. Methods and Results: Two-dimensional (2D) and three-dimensional (3D) IVUS imaging has been used routinely in more than 100 patients following carotid stenting and the completion angiogram to detect evidence of inaccurate stent deployment. Axial 2D views were used to measure diameters and cross-sectional areas and provide the basis for 3D reconstruction. These composited images produced single-frame views of entire vascular segments, with definition of vessel wall morphology, stent placement, and angioplasty-induced defects. This information was used in the decision to apply further treatment to the area in order to maximize luminal diameter and/or correct defects. Conclusions: IVUS imaging is an important component of carotid artery stent procedures. It more accurately visualizes stent placement and vessel wall morphology than arteriography, information critical to the intraprocedural assessment process.