Intravascular ultrasound is a diagnostic procedure used to look inside a coronary artery.
An intravascular ultrasound (IVUS), also called an endovascular ultrasound or intravascular echocardiography, is an invasive imaging procedure that helps diagnose and treat various conditions that affect the coronary arteries (the blood vessels supplying the heart) and other blood vessels.
- Diagnostic uses of IVUS: IVUS is used to diagnose any thickening, narrowing, blocking, or clotting in the blood vessels. Thus, it may be used to diagnose conditions such as:
- Peripheral artery disease (narrowing of the arteries that carry blood from the heart to other parts of the body such as the legs)
- Coronary artery disease (narrowing of the arteries that supply blood to the heart)
- Aortic dissection (a tear in the inner layer of the major blood vessel called the aorta)
- Atherosclerosis (hardening of the walls of arteries due to plaque buildup)
- Aortic aneurysm (balloon-like bulging of the aorta)
- Stent restenosis (blockage of a stent)
- Therapeutic uses of IVUS: IVUS can be used to perform certain procedures such as clot removal surgery or repair of a blood vessel (angioplasty) because it provides a clear image of the inside of the blood vessels. It can help measure the size of veins so that the doctor can choose a stent of an appropriate size for vascular stenting. Additionally, it helps determine the suitable site for stent placement. IVUS helps assess abdominal aortic aneurysm before, during, and after the repair surgery.
What should you do before an intravascular ultrasound?
- You must tell your doctor before the surgery if you have any contrast allergies or underlying health conditions (such as kidney diseases and diabetes) or take any medications. Your doctor will discuss with you whether you need to take any medications before the procedure.
- Women undergoing this procedure must inform their doctor if they are pregnant or breastfeeding.
- Your doctor will tell you whether you need to stop eating and drinking before the procedure (four to eight hours before the procedure if sedation is used).
What happens during an intravascular ultrasound?
Intravascular ultrasound (IVUS) is generally an outpatient procedure (you do not need to stay overnight in the hospital). However, your hospital stay will be determined by additional procedures that may be needed. You may need someone to drive you back home after the procedure.
Generally, the procedure is done under sedation although general anesthesia may be used in some cases.
- During IVUS, the doctor inserts a thin and flexible tube called a catheter through a blood vessel (artery or vein) into the target location. You may feel a slight pinch when the catheter is inserted. Usually, the catheter is inserted through the groin and then threaded toward the heart.
- The catheter carries a small device called an ultrasound transducer at one end. The transducer generates special sound waves (ultrasonic waves) that create images of the inside of the blood vessels.
- The images are viewed by the doctor on the screen which helps them assess the disease condition. To better enhance the images, the doctor may use a dye or contrast during the procedure.
What happens after an intravascular ultrasound?
After the procedure, the doctor will remove the catheter and apply a bandage. They may apply some pressure at the insertion site to prevent bleeding. The doctor may ask you to drink plenty of fluids following the procedure. You must avoid physical exertion for about 24 hours after the procedure.
Contact your doctor if you develop any of the symptoms:
- Bleeding
- Breathlessness
- Severe pain
- Pain or swelling at the catheter insertion site
- Swelling in the legs
What are the risks of an intravascular ultrasound?
Intravascular ultrasound (IVUS) is generally a safe procedure when performed by an experienced surgeon after proper patient selection.
Some of the risks of an IVUS include:
- Transient coronary spasm (narrowing of the coronary artery)
- Blood vessel injury
- Infection
- Allergic reactions (when contrast is used)
- Bleeding
- Blood clot formation or displacement (such as blood clot in the lungs)
- Anesthesia-related complications
- Breathing issues
- Heart valve injury
- Arrhythmia (abnormal heart rhythm)
- Heart attack
- Stroke (rare)
- Renal failure (particularly in people with underlying kidney diseases or diabetes)