Intravascular ultrasound for iliac artery imaging. Clinical review

IVUS is able to produce trans-sectional images of the iliac arteries at a high resolution. The three layered appearance of the arterial wall can be visualized. In the atherosclerotic diseased artery calcified plaques can be discerned from non-calcified plaques, and the distribution of the plaque-eccentric or concentric-can be determined. IVUS seems to be superior to arteriography in quantifying the degree of stenosis, being able to relate the luminal area to the mediabounded area at the same site of the artery. The discrepancy between IVUS and arteriography is even greater when evaluating residualstenosis after PTA. Structures such as rupture, intimal flaps and dissection are better visualized with IVUS. In stenotic iliac arteries IVUS has been able to evaluate the effect of PTA and stenting and relating the effect to the morphology of the plaque. IVUS measurements seem to be important predictors of the patency of iliac PTA. The ability of IVUS to evaluate the adaptation of stents to the arterial wall makes it particularly suited as a control procedure for the deployment of endovascular stented grafts. Finally IVUS has the ability to disclose insufficiency of endarterecomy, by visualizing remaining intraluminal material.