Percutaneous coronary intervention intravascular ultrasound

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Patient Information

Overview

PCI Approaches:

CAD Revascularization:

Heart Team Approach to Revascularization Decisions
Left Main Coronary Artery Disease
Intervention in left main coronary artery disease
Non-Left Main Coronary Artery Disease
Revascularization to Improve Symptoms
Dual Antiplatelet Therapy Compliance and Stent Thrombosis
Hybrid Coronary Revascularization

Pre-procedural Considerations:

Contrast-Induced Acute Kidney Injury
Anaphylactoid Reactions
Statin Treatment
Bleeding Risk
Role of Onsite Surgical Backup

Procedural Considerations:

Vascular Access
PCI in Specific Clinical Situations:
Asymptomatic Ischemia or CCS Class I or II Angina
CCS Class III Angina
Unstable Angina/Non–ST-Elevation Myocardial Infarction
ST-Elevation Myocardial Infarction:
General and Specific Considerations
Coronary Angiography Strategies in STEMI
Primary PCI of the Infarct Artery
Delayed or Elective PCI in patients with STEMI
Fibrinolytic-Ineligible Patients
Facilitated PCI
Rescue PCI
After Successful Fibrinolysis or for Patients Not Undergoing Primary Reperfusion
Cardiogenic Shock
Prior Coronary Bypass Surgery
Revascularization Before Non-cardiac Surgery
Adjunctive Diagnostic Devices:
Fractional Flow Reserve
Intravascular Ultrasound
Adjunctive Therapeutic Devices:
Coronary Atherectomy
Thrombectomy
Laser Angioplasty
Cutting Balloon Angioplasty
Embolic Protection Devices
Percutaneous Hemodynamic Support Devices
Antiplatelet therapy:
Oral Antiplatelet Therapy
Glycoprotein IIb/IIIa Receptor Antagonists
Intravenous Antiplatelet therapy:
STEMI
UA/NSTEMI
SIHD
Anticoagulant Therapy:
Parenteral Anticoagulants During PCI
Unfractionated Heparin
Enoxaparin
Bivalirudin and Argatroban
Fondaparinux
No-Reflow Pharmacological Therapies
PCI in Specific Anatomic Situations:
Chronic Total Occlusions
Saphenous Vein Grafts
Bifurcation Lesions
Aorto-Ostial Stenoses
Calcified Lesions
PCI in Specific Patient Populations:
Chronic Kidney Disease
Peri-procedural Myocardial Infarction Assessment
Vascular Closure Devices

Post-Procedural Considerations:

Post-procedural Antiplatelet Therapy
Proton Pump Inhibitors and Antiplatelet Therapy
Clopidogrel Genetic Testing
Platelet Function Testing
Restenosis
Exercise Testing
Cardiac Rehabilitation

Quality and Performance Considerations:

Quality and Performance
Certification and Maintenance of Certification
Operator and Institutional Competency and Volume

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

ACCF/AHA/SCAI 2011 Guidelines for Percutaneous Coronary Intervention: Intravascular Ultrasound[1] (DO NOT EDIT)

Class III (No Benefit)
"1. IVUS for routine lesion assessment is not recommended when revascularization with PCI or CABG is not being contemplated. (Level of Evidence: C)"
Class IIa
"1. Intravascular ultrasound (IVUS) is reasonable for the assessment of angiographically indeterminant left main CAD.[2][3][4] (Level of Evidence: B)"
"2. IVUS and coronary angiography are reasonable 4 to 6 weeks and 1 year after cardiac transplantation to exclude donor CAD, detect rapidly progressive cardiac allograft vasculopathy, and provide prognostic information.[5][6][7] (Level of Evidence: B)"
"3. IVUS is reasonable to determine the mechanism of stent restenosis. [8] (Level of Evidence: C)"
Class IIb
"1. IVUS may be reasonable for the assessment of non–left main coronary arteries with angiographically intermediate coronary stenoses (50% to 70% diameter stenosis).[2][9][10] (Level of Evidence: B)"
"2. IVUS may be considered for guidance of coronary stent implantation, particularly in cases of left main coronary artery stenting.[3][8][11] (Level of Evidence: B)"
"3. IVUS may be reasonable to determine the mechanism of stent thrombosis.[8] (Level of Evidence: C)"

References

  1. Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, Chambers CE, Ellis SG, Guyton RA, Hollenberg SM, Khot UN, Lange RA, Mauri L, Mehran R, Moussa ID, Mukherjee D, Nallamothu BK, Ting HH (2011). "2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: Executive Summary A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions" (PDF). Journal of the American College of Cardiology. 58 (24): 2550–83. doi:10.1016/j.jacc.2011.08.006. PMID 22070837. Retrieved 2011-12-08. Text "PDF" ignored (help); Unknown parameter |month= ignored (help)
  2. 2.0 2.1 Briguori C, Anzuini A, Airoldi F, Gimelli G, Nishida T, Adamian M, Corvaja N, Di Mario C, Colombo A (2001). "Intravascular ultrasound criteria for the assessment of the functional significance of intermediate coronary artery stenoses and comparison with fractional flow reserve". The American Journal of Cardiology. 87 (2): 136–41. PMID 11152827. Retrieved 2011-12-09. Unknown parameter |month= ignored (help)
  3. 3.0 3.1 Fassa AA, Wagatsuma K, Higano ST, Mathew V, Barsness GW, Lennon RJ, Holmes DR, Lerman A (2005). "Intravascular ultrasound-guided treatment for angiographically indeterminate left main coronary artery disease: a long-term follow-up study". Journal of the American College of Cardiology. 45 (2): 204–11. doi:10.1016/j.jacc.2004.09.066. PMID 15653016. Retrieved 2011-12-09. Unknown parameter |month= ignored (help)
  4. Kang SJ, Lee JY, Ahn JM, Mintz GS, Kim WJ, Park DW, Yun SC, Lee SW, Kim YH, Lee CW, Park SW, Park SJ (2011). "Validation of intravascular ultrasound-derived parameters with fractional flow reserve for assessment of coronary stenosis severity". Circulation. Cardiovascular Interventions. 4 (1): 65–71. doi:10.1161/CIRCINTERVENTIONS.110.959148. PMID 21266708. Retrieved 2011-12-09. Unknown parameter |month= ignored (help)
  5. Costanzo MR, Dipchand A, Starling R, Anderson A, Chan M, Desai S, Fedson S, Fisher P, Gonzales-Stawinski G, Martinelli L, McGiffin D, Smith J, Taylor D, Meiser B, Webber S, Baran D, Carboni M, Dengler T, Feldman D, Frigerio M, Kfoury A, Kim D, Kobashigawa J, Shullo M, Stehlik J, Teuteberg J, Uber P, Zuckermann A, Hunt S, Burch M, Bhat G, Canter C, Chinnock R, Crespo-Leiro M, Delgado R, Dobbels F, Grady K, Kao W, Lamour J, Parry G, Patel J, Pini D, Towbin J, Wolfel G, Delgado D, Eisen H, Goldberg L, Hosenpud J, Johnson M, Keogh A, Lewis C, O'Connell J, Rogers J, Ross H, Russell S, Vanhaecke J (2010). "The International Society of Heart and Lung Transplantation Guidelines for the care of heart transplant recipients". The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation. 29 (8): 914–56. doi:10.1016/j.healun.2010.05.034. PMID 20643330. Retrieved 2011-12-10. Unknown parameter |month= ignored (help)
  6. Kobashigawa JA, Tobis JM, Starling RC, Tuzcu EM, Smith AL, Valantine HA, Yeung AC, Mehra MR, Anzai H, Oeser BT, Abeywickrama KH, Murphy J, Cretin N (2005). "Multicenter intravascular ultrasound validation study among heart transplant recipients: outcomes after five years". Journal of the American College of Cardiology. 45 (9): 1532–7. doi:10.1016/j.jacc.2005.02.035. PMID 15862430. Retrieved 2011-12-10. Unknown parameter |month= ignored (help)
  7. Kapadia SR, Nissen SE, Ziada KM, Guetta V, Crowe TD, Hobbs RE, Starling RC, Young JB, Tuzcu EM (1998). "Development of transplantation vasculopathy and progression of donor-transmitted atherosclerosis: comparison by serial intravascular ultrasound imaging". Circulation. 98 (24): 2672–8. PMID 9851952. Retrieved 2011-12-10. Unknown parameter |month= ignored (help)
  8. 8.0 8.1 8.2 Dangas GD, Claessen BE, Caixeta A, Sanidas EA, Mintz GS, Mehran R (2010). "In-stent restenosis in the drug-eluting stent era". Journal of the American College of Cardiology. 56 (23): 1897–907. doi:10.1016/j.jacc.2010.07.028. PMID 21109112. Retrieved 2011-12-10. Unknown parameter |month= ignored (help)
  9. Takagi A, Tsurumi Y, Ishii Y, Suzuki K, Kawana M, Kasanuki H (1999). "Clinical potential of intravascular ultrasound for physiological assessment of coronary stenosis: relationship between quantitative ultrasound tomography and pressure-derived fractional flow reserve". Circulation. 100 (3): 250–5. PMID 10411848. Retrieved 2011-12-10. Unknown parameter |month= ignored (help)
  10. Magni V, Chieffo A, Colombo A (2009). "Evaluation of intermediate coronary stenosis with intravascular ultrasound and fractional flow reserve: Its use and abuse". Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions. 73 (4): 441–8. doi:10.1002/ccd.21812. PMID 19133668. Retrieved 2011-12-10. Unknown parameter |month= ignored (help)
  11. Park SJ, Kim YH, Park DW, Lee SW, Kim WJ, Suh J, Yun SC, Lee CW, Hong MK, Lee JH, Park SW (2009). "Impact of intravascular ultrasound guidance on long-term mortality in stenting for unprotected left main coronary artery stenosis". Circulation. Cardiovascular Interventions. 2 (3): 167–77. doi:10.1161/CIRCINTERVENTIONS.108.799494. PMID 20031713. Retrieved 2011-12-10. Unknown parameter |month= ignored (help)

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