PMID: 9173698Feb 1, 1997Paper

Intracoronary ultrasound changes the therapeutic approach in ambivalent angiography findings

Zeitschrift für Kardiologie
J BruchhäuserE Erdmann

Abstract

Despite careful evaluation of multiple projections, coronary angiography may give ambiguous results of lesion severity. The purpose of this study was to analyze the impact of ultrasound imaging on revascularization treatment strategy in angiographically ambiguous findings. We reviewed our experience with such equivocal angiographic findings before intervention in 31 patients (34 lesions) who had additional intravascular ultrasound (IVUS) to clarify coronary anatomy. Intervention was felt to be indicated if area stenosis by IVUS exceeded 50% in the left main or 75% in other major coronary arteries. To evaluate the clinical efficacy of IVUS based management strategies, all patients had clinical follow-up after 1 year. Seven of nine ostial lesions were overestimated by angiography, but two of three left main lesions were found to be significant. Seven lesions in one of the proximal coronary arteries whose significance was difficult to judge by angiography were found not to be significant by IVUS, whereas in the other four severe obstruction was confirmed. Membranes by angiography corresponded to remnants of ruptured plaques by IVUS in all five patients. However, significant narrowing was found in only two patients. Side branch ost...Continue Reading

Citations

Sep 2, 1999·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·S N OesterleP J Fitzgerald

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