PMID: 19935603Nov 26, 2009Paper

Use of intravascular ultrasound as a "Quality Control" technique during carotid stent-angioplasty: are there risks to its use?

The Journal of Cardiovascular Surgery
D F Bandyk, Paul A Armstrong

Abstract

Intravascular ultrasound (IVUS) provides high-resolution vessel imaging and has been shown to improve clinical outcomes when used to assess the technical result of peripheral angioplasty procedures. Our vascular group compared anatomic and clinical outcomes of carotid artery stent-angioplasty (CAS) performed with angiogram monitoring alone, or in combination with IVUS imaging to select stent/balloon diameter and interrogate stent deployment region for residual stenosis. A retrospective review of our carotid stent registry (N=306) identified 220 CAS procedures performed with either a digital C-arm fluoroscopy alone (N=110) or in conjunction with IVUS (N=110) with at least 6-month of clinical follow-up. Outcome measures of procedure time, angioplasty balloon diameter, contrast dye volume, Duplex surveillance testing for recurrent stenosis, and procedure event (death, cardiac, neurologic) rates were compared to assess the risks and benefits of IVUS. All procedures utilized a cerebral protection device deployed prior to IVUS imaging. Procedure times were similar, but IVUS usage resulted in lower (P<0.05) contrast agent volumes due to fewer angiogram runs for stent sizing and verification of adequate stent deployment. IVUS imaging r...Continue Reading

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