Utility of intravascular ultrasound in peripheral intervention part 3

Intravascular ultrasound during intravascular stent delivery

Intravascular stents are currently used for many applications, including the prevention and treatment of complications associated with percutaneous transluminal angioplasty. Although stent has increased the patency rates of several endovascular procedures, it is not without risks. Many of the complications are related to inappropriate selection of lesions for treatment with stents, or maldeployment of stents. Inadequate stent expansions can lead to early thrombosis or stent migration, and over-expansion of the stent can result in excessive intimal hyperplasia or vessel perforation. Intravascular ultrasound has been particularly useful for stent placement in both coronary and peripheral lesions.

Three-dimensional reconstruction is particularly useful to assess the completeness of the stent expansion. On the reconstructed images of the stented vessel, the stent structure can be seen as independent of the arterial walls. Thus, incomplete stent implantation is evident. The incorporation of an intravascular ultrasound transducer into the stent delivery system will permit simultaneous imaging during stent delivery, enhancing the precision of the procedure.