The Role of Intravascular Ultrasound (IVUS) In Guiding Interventions for Patients with Aberrant Coronary Arteries: A Comprehensive Review
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Abstract
Aberrant coronary arteries present unique challenges in diagnostic and interventional cardiology due to their atypical anatomy, high variability, and potential association with adverse cardiac events. Intravascular ultrasound (IVUS), as an intraluminal imaging modality, has emerged as a critical tool in guiding interventions in this subset of patients. IVUS provides high-resolution cross-sectional images of vessel morphology, allowing precise assessment of luminal dimensions, plaque burden, and stent positioning, especially in anatomically complex regions where conventional angiography falls short. This review explores the utility of IVUS in the evaluation and management of aberrant coronary arteries, highlighting its role in minimizing complications, optimizing procedural outcomes, and advancing our understanding of these rare but clinically significant anomalies. We also discuss the integration of IVUS with adjunctive imaging modalities, technical considerations, and future perspectives in the field.
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References
I. Topol EJ, Nissen SE. Our preoccupation with coronary luminology. The dissociation between clinical and angiographic findings in ischemic heart disease. Circulation 1995;92:2333-42.
1161/01.CIR.92.8.2333
II. Zir LM, Miller SW, Dinsmore RE, et al. Interobserver variability in coronary angiography. Circulation 1976;53:627-32.
1161/01.CIR.53.4.627
III. Lotfi A, Davies JE, Fearon WF, et al. Focused update of expert consensus statement: Use of invasive assessments of coronary physiology and structure: A position statement of the society of cardiac angiography and interventions. Catheter Cardiovasc Interv 2018;92:336-47.
1002/ccd.27672
IV. .Kornowski R, Mintz GS, Kent KM, et al. Increased restenosis in diabetes mellitus after coronary interventions is due to exaggerated intimal hyperplasia. A serial intravascular ultrasound study. Circulation 1997;95:1366-9.
1161/01.CIR.95.6.1366
V. Lotfi A, Jeremias A, Fearon WF, et al. Expert consensus statement on the use of fractional flow reserve, intravascular ultrasound, and optical coherence tomography: a consensus statement of the society of cardiovascular angiography and interventions. Catheter Cardiovasc Interv 2014;83:509-18. 10.1002/ccd.25222
VI. McDaniel MC, Eshtehardi P, Sawaya FJ, et al. Contemporary clinical applications of coronary intravascular ultrasound. JACC Cardiovasc Interv 2011;4:1155-67. 10.1016/j.jcin.2011.07.013
VII. Smith SC, Jr, Feldman TE, Hirshfeld JW, Jr, et al. ACC/AHA/SCAI 2005 guideline update for percutaneous coronary intervention: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/SCAI Writing Committee to Update 2001 Guidelines for Percutaneous Coronary Intervention). Circulation 2006;113:e166-286.
VIII. Yamagishi M, Terashima M, Awano K, et al. Morphology of vulnerable coronary plaque: insights from follow-up of patients examined by intravascular ultrasound before an acute coronary syndrome. J Am Coll Cardiol 2000;35:106-11. 10.1016/S0735-1097(99)00533-1
IX. Takano M, Mizuno K, Okamatsu K, et al. Mechanical and structural characteristics of vulnerable plaques: analysis by coronary angioscopy and intravascular ultrasound. J Am Coll Cardiol 2001;38:99-104. 10.1016/S0735-1097(01)01315-8
X. Garcia-Garcia HM, Costa MA, Serruys PW. Imaging of coronary atherosclerosis: intravascular ultrasound. Eur Heart J 2010;31:2456-69.
1093/eurheartj/ehq280
XI. Zheng M, Choi SY, Tahk SJ, et al. The relationship between volumetric plaque components and classical cardiovascular risk factors and the metabolic syndrome a 3-vessel coronary artery virtual histology-intravascular ultrasound analysis. JACC Cardiovasc Interv 2011;4:503-10.
1016/j.jcin.2010.12.015
XII. Ramadan R, Boden WE, Kinlay S. Management of Left Main Coronary Artery Disease. J Am Heart Assoc 2018;7. 10.1161/JAHA.117.008151
XIII. Uren NG, Schwarzacher SP, Metz JA, et al. Predictors and outcomes of stent thrombosis: an intravascular ultrasound registry. Eur Heart J 2002;23:124-32. 10.1053/euhj.2001.2707
XIV. Kasaoka S, Tobis JM, Akiyama T, et al. Angiographic and intravascular ultrasound predictors of in-stent restenosis. J Am Coll Cardiol 1998;32:1630-5. 10.1016/S0735-1097(98)00404-5
XV. Hoffmann R, Mintz GS, Mehran R, et al. Intravascular ultrasound predictors of angiographic restenosis in lesions treated with Palmaz-Schatz stents. J Am Coll Cardiol 1998;31:43-9.
1016/S0735-1097(97)00438-5
XVI. .Jang JS, Song YJ, Kang W, et al. Intravascular ultrasound-guided implantation of drug-eluting stents to improve outcome: a meta-analysis. JACC Cardiovasc Interv 2014;7:233-43.
1016/j.jcin.2013.09.013
XVII. Moses JW, Dangas G, Mehran R, et al. Drug-eluting stents in the real world: how intravascular ultrasound can improve clinical outcome. Am J Cardiol 2008;102:24J-8J.
1016/j.amjcard.2008.09.006