When is an intravascular ultrasound (IVUS) used?

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If you have heart disease, your physician may want to assess the health of the inside of your coronary arteries, which supply blood to your heart. To gather highly detailed images of the artery wall, your physician may use a diagnostic test called intravascular ultrasound (IVUS).

You might already be familiar with ultrasound tests. (Pregnant women receive them, for example, to assess the health and progress of a growing baby.) Ultrasound is a procedure that transmits high-frequency sound waves through body tissues. These sound waves create echoes that are turned into video or photographic images of the organs and internal structures in the body. Ultrasounds can be used to diagnosis a variety of diseases and conditions.

In IVUS, the ultrasound wand that transmits and receives sound waves is inside the body. A physician called an interventional cardiologist threads a thin, flexible tube called a catheter through an artery. This catheter emits sound waves from the tip and then receives the echoes. The echoes show detailed images of a section of the artery wall, including problems such as build-up of a fatty substance called plaque that clogs the arteries or an aneurysm (a bulge in the artery wall caused by a weak spot). IVUS is also used to help interventional cardiologists reopen blocked arteries and place tiny mesh-like metal tubes called stents that prop an artery open. Then IVUS can be used to assess the success of the stent placement. IVUS also provides detailed images of calcium deposits in the wall of the heart arteries. Interventional cardiologists use these images to guide a drilling device called a rotablator, which is used to clear a blockage before placing a stent.