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Current Cardiovascular Imaging Reports

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01-02-2020 | Angiography | Intravascular Imaging (A Truesdell, Section Editor)

Intravascular Imaging for Peripheral Vascular Disease and Endovascular Intervention

Authors: Eric Rothstein, Herbert Aronow, Beau M. Hawkins, Michael N. Young

Published in: Current Cardiovascular Imaging Reports | Issue 2/2020

Abstract

Purpose of Review

Intravascular imaging has been increasingly incorporated into endovascular practice. The goal of this review is to explore the contemporary technologies used to perform intravascular imaging as well as the evidence supporting their use in the diagnostic assessment and treatment of peripheral vascular disease.

Recent Findings

Although intravascular imaging has been more extensively studied in the coronary vasculature, there is a growing body of literature studying its use in other vascular territories. There are unique advantages and disadvantages for the two most commonly employed imaging modalities—intravascular ultrasound (IVUS) and optical coherence tomography (OCT). Either may enhance the diagnostic capabilities of conventional angiography depending upon the clinical situation. IVUS and OCT guidance for angioplasty and stent sizing in peripheral interventions has been shown to be safe, feasible and in many instances, effective. Studies suggest that clinically relevant outcomes such as vessel primary patency and long-term patency may be improved by utilizing these imaging technologies.

Summary

While still employed as adjunctive modalities to angiography and peripheral intervention, IVUS or OCT may provide a potential pathway towards improving short- and long-term outcomes for a variety of vascular disease entities. At this time, further research is still warranted to better define the optimal role for these devices in non-coronary vascular beds.

Hong SJ, et al. Effect of intravascular ultrasound-guided vs angiography-guided everolimus-eluting stent implantation: the IVUS-XPL randomized clinical trial. Jama. 2015;314(20):2155–63.PubMedCrossRef

Zhang J, et al. Intravascular ultrasound versus angiography-guided drug-eluting stent implantation: the ULTIMATE trial. J Am Coll Cardiol. 2018;72(24):3126–37.PubMedCrossRef

Gao XF, et al. Intravascular ultrasound guidance reduces cardiac death and coronary revascularization in patients undergoing drug-eluting stent implantation: results from a meta-analysis of 9 randomized trials and 4724 patients. Int J Card Imaging. 2019;35(2):239–47.CrossRef

Fujii K, et al. Stent underexpansion and residual reference segment stenosis are related to stent thrombosis after sirolimus-eluting stent implantation: an intravascular ultrasound study. J Am Coll Cardiol. 2005;45(7):995–8.PubMedCrossRef

Tian NL, et al. Angiographic and clinical comparisons of intravascular ultrasound- versus angiography-guided drug-eluting stent implantation for patients with chronic total occlusion lesions: two-year results from a randomised AIR-CTO study. EuroIntervention. 2015;10(12):1409–17.PubMedCrossRef

Chen L, et al. Intravascular ultrasound-guided drug-eluting stent implantation is associated with improved clinical outcomes in patients with unstable angina and complex coronary artery true bifurcation lesions. Int J Card Imaging. 2018;34(11):1685–96.CrossRef

Jakabcin J, et al. Long-term health outcome and mortality evaluation after invasive coronary treatment using drug eluting stents with or without the IVUS guidance. Randomized control trial. HOME DES IVUS. Catheter Cardiovasc Interv. 2010;75(4):578–83.PubMedCrossRef

Kang SJ, Mintz GS. Outcomes with intravascular ultrasound-guided stent implantation: a meta-analysis of randomized trials in the era of drug-eluting stents. J Thorac Dis. 2016;8(8):E841–3.PubMedPubMedCentralCrossRef

Bavishi C, et al. Intravascular ultrasound-guided vs angiography-guided drug-eluting stent implantation in complex coronary lesions: meta-analysis of randomized trials. Am Heart J. 2017;185:26–34.PubMedCrossRef

10.

•• Makris GC, et al. The role of intravascular ultrasound in lower limb revascularization in patients with peripheral arterial disease. Int Angiol. 2017;36(6):505–16 This study provided an analysis of thirteen studies where IVUS-guided peripheral arterial intervention was compared to angiographic-guided intervention, and demonstrated a significant benefit with regards to patency and amputation rates.PubMedCrossRef

11.

Panaich SS, et al. Intravascular ultrasound in lower extremity peripheral vascular interventions: variation in utilization and impact on in-hospital outcomes from the nationwide inpatient sample (2006-2011). J Endovasc Ther. 2016;23(1):65–75.PubMedCrossRef

12.

Lin E, Alessio A. What are the basic concepts of temporal, contrast, and spatial resolution in cardiac CT? J Cardiovasc Comput Tomogr. 2009;3(6):403–8.PubMedPubMedCentralCrossRef

13.

American College of Cardiology Clinical Expert Consensus Document on Standards for Acquisition, Measurement and Reporting of Intravascular Ultrasound Studies (IVUS). A report of the American College of Cardiology Task Force on Clinical Expert Consensus Documents developed in collaboration with the European Society of Cardiology endorsed by the Society of Cardiac Angiography and Interventions. Eur J Echocardiogr, 2001. 2(4): p. 299–313.

14.

Kume T, Uemura S. Current clinical applications of coronary optical coherence tomography. Cardiovasc Interv Ther. 2018;33(1):1–10.PubMedCrossRef

15.

Tearney GJ, et al. Consensus standards for acquisition, measurement, and reporting of intravascular optical coherence tomography studies: a report from the International Working Group for Intravascular Optical Coherence Tomography Standardization and Validation. J Am Coll Cardiol. 2012;59(12):1058–72.PubMedCrossRef

16.

Maehara A, et al. IVUS-guided versus OCT-guided coronary stent implantation: a critical appraisal. JACC Cardiovasc Imaging. 2017;10(12):1487–503.PubMedCrossRef

17.

Stefano GT, Mehanna E, Parikh SA. Imaging a spiral dissection of the superficial femoral artery in high resolution with optical coherence tomography—seeing is believing. Catheter Cardiovasc Interv. 2013;81(3):568–72.PubMedCrossRef

18.

Ali ZA, et al. Optical coherence tomography compared with intravascular ultrasound and with angiography to guide coronary stent implantation (ILUMIEN III: OPTIMIZE PCI): a randomised controlled trial. Lancet. 2016;388(10060):2618–28.PubMedCrossRef

19.

Otake H, et al. Optical frequency domain imaging versus intravascular ultrasound in percutaneous coronary intervention (OPINION trial): results from the OPINION imaging study. JACC Cardiovasc Imaging. 2018;11(1):111–23.PubMedCrossRef

20.

Yin D, et al. Comparison of plaque morphology between peripheral and coronary artery disease (from the CLARITY and ADAPT-DES IVUS substudies). Coron Artery Dis. 2017;28(5):369–75.PubMedCrossRef

21.

Wei H, et al. The value of intravascular ultrasound imaging in diagnosis of aortic penetrating atherosclerotic ulcer. EuroIntervention. 2006;1(4):432–7.PubMed

22.

Hu W, et al. The potential value of intravascular ultrasound imaging in diagnosis of aortic intramural hematoma. J Geriatr Cardiol. 2011;8(4):224–9.PubMedPubMedCentral

23.

Diethrich EB, Irshad K, Reid DB. Virtual histology and color flow intravascular ultrasound in peripheral interventions. Semin Vasc Surg. 2006;19(3):155–62.PubMedCrossRef

24.

Fuchs M, et al. Ex vivo characterization of carotid plaques by intravascular ultrasonography and virtual histology: concordance with real plaque pathomorphology. J Cardiovasc Surg. 2017;58(1):55–64.CrossRef

25.

Musialek P, et al. Safety of embolic protection device-assisted and unprotected intravascular ultrasound in evaluating carotid artery atherosclerotic lesions. Med Sci Monit. 2012;18(2):Mt7–18.PubMedPubMedCentralCrossRef

26.

Iida O, et al. Efficacy of intravascular ultrasound in femoropopliteal stenting for peripheral artery disease with TASC II class A to C lesions. J Endovasc Ther. 2014;21(4):485–92.PubMedCrossRef

27.

Inglese L, Fantoni C, Sardana V. Can IVUS-virtual histology improve outcomes of percutaneous carotid treatment? J Cardiovasc Surg. 2009;50(6):735–44.

28.

Yamada K, et al. Prediction of silent ischemic lesions after carotid artery stenting using virtual histology intravascular ultrasound. Cerebrovasc Dis. 2011;32(2):106–13.PubMedCrossRef

29.

Takumi T, et al. The association between renal atherosclerotic plaque characteristics and renal function before and after renal artery intervention. Mayo Clin Proc. 2011;86(12):1165–72.PubMedPubMedCentralCrossRef

30.

Yoshimura S, et al. Visualization of internal carotid artery atherosclerotic plaques in symptomatic and asymptomatic patients: a comparison of optical coherence tomography and intravascular ultrasound. AJNR Am J Neuroradiol. 2012;33(2):308–13.PubMedCrossRefPubMedCentral

31.

Janosi RA, et al. Validation of intravascular ultrasound for measurement of aortic diameters: comparison with multi-detector computed tomography. Minim Invasive Ther Allied Technol. 2015;24(5):289–95.PubMedCrossRef

32.

Song TK, et al. Intravascular ultrasound use in the treatment of thoracoabdominal dissections, aneurysms, and transections. Semin Vasc Surg. 2006;19(3):145–9.PubMedCrossRef

33.

White RA, et al. Intraprocedural imaging: thoracic aortography techniques, intravascular ultrasound, and special equipment. J Vasc Surg. 2006;43 Suppl A:53a–61a.PubMedCrossRef

34.

Han SM, et al. Comparison of intravascular ultrasound- and centerline computed tomography-determined aortic diameters during thoracic endovascular aortic repair. J Vasc Surg. 2017;66(4):1184–91.PubMedCrossRef

35.

Hu W, et al. Value of intravascular ultrasound imaging in following up patients with replacement of the ascending aorta for acute type A aortic dissection. Chin Med J. 2008;121(21):2139–43.PubMedCrossRef

36.

Lortz J, et al. Intravascular ultrasound assisted sizing in thoracic endovascular aortic repair improves aortic remodeling in type B aortic dissection. PLoS One. 2018;13(4):e0196180.PubMedPubMedCentralCrossRef

37.

Jiang JH, et al. The application of intravascular ultrasound imaging in the diagnosis of aortic dissection. Zhonghua Wai Ke Za Zhi. 2003;41(7):491–4.PubMed

38.

Jiang JH, et al. The application of intravascular ultrasound imaging in identifying the visceral artery in aortic dissection. Zhonghua Yi Xue Za Zhi. 2003;83(18):1580–2.PubMed

39.

Leshnower BG, et al. Aortic remodeling after endovascular repair of complicated acute type B aortic dissection. Ann Thorac Surg. 2017;103(6):1878–85.PubMedCrossRef

40.

Shi Z, et al. Outcomes and aortic remodelling after proximal thoracic endovascular aortic repair of post type B aortic dissection thoracic aneurysm. Vasa. 2016;45(4):331–6.PubMedCrossRef

41.

Lortz J, et al. Hemodynamic changes lead to alterations in aortic diameters and may challenge further stent graft sizing in acute aortic syndrome. J Thorac Dis. 2018;10(6):3482–9.PubMedPubMedCentralCrossRef

42.

Tutein Nolthenius RP, van den Berg JC, Moll FL. The value of intraoperative intravascular ultrasound for determining stent graft size (excluding abdominal aortic aneurysm) with a modular system. Ann Vasc Surg. 2000;14(4):311–7.PubMedCrossRef

43.

Husmann MJ, et al. Intravascular ultrasound-guided creation of re-entry sites to improve intermittent claudication in patients with aortic dissection. J Endovasc Ther. 2006;13(3):424–8.PubMedCrossRef

44.

Miki K, et al. Impact of intravascular ultrasound findings on long-term patency after self-expanding nitinol stent implantation in the iliac artery lesion. Heart Vessel. 2016;31(4):519–27.CrossRef

45.

Arko F, et al. Use of intravascular ultrasound improves long-term clinical outcome in the endovascular management of atherosclerotic aortoiliac occlusive disease. J Vasc Surg. 1998;27(4):614–23.PubMedCrossRef

46.

Buckley CJ, et al. Intravascular ultrasound scanning improves long-term patency of iliac lesions treated with balloon angioplasty and primary stenting. J Vasc Surg. 2002;35(2):316–23.PubMedCrossRef

47.

Kasaoka S, et al. Angiographic and intravascular ultrasound predictors of in-stent restenosis. J Am Coll Cardiol. 1998;32(6):1630–5.PubMedCrossRef

48.

Cheneau E, et al. Predictors of subacute stent thrombosis: results of a systematic intravascular ultrasound study. Circulation. 2003;108(1):43–7.PubMedCrossRef

49.

Kumakura H, et al. 15-year patency and life expectancy after primary stenting guided by intravascular ultrasound for iliac artery lesions in peripheral arterial disease. JACC Cardiovasc Interv. 2015;8(14):1893–901.PubMedCrossRef

50.

Hitchner E, et al. A prospective evaluation of using IVUS during percutaneous superficial femoral artery interventions. Ann Vasc Surg. 2015;29(1):28–33.PubMedCrossRef

51.

Miki K, et al. Impact of post-procedural intravascular ultrasound findings on long-term results following self-expanding nitinol stenting in superficial femoral artery lesions. Circ J. 2013;77(6):1543–50.PubMedCrossRef

52.

• Miki K, et al. Intravascular ultrasound-derived stent dimensions as predictors of angiographic restenosis following nitinol stent implantation in the superficial femoral artery. J Endovasc Ther. 2016;23(3):424–32 This study examined IVUS-derived post-procedure parameters in superficial femoral artery interventions and their association with in-stent restenosis, suggesting that adequate stent expansion improved long-term patency.PubMedCrossRef

53.

Shammas NW, Torey JT, Shammas WJ. Dissections in peripheral vascular interventions: a proposed classification using intravascular ultrasound. J Invasive Cardiol. 2018;30(4):145–6.PubMed

54.

Kusuyama T, Iida H, Mitsui H. Intravascular ultrasound complements the diagnostic capability of carbon dioxide digital subtraction angiography for patients with allergies to iodinated contrast medium. Catheter Cardiovasc Interv. 2012;80(6):E82–6.PubMedCrossRef

55.

Hoshino Y, et al. Successful treatment of renovascular hypertension due to fibromuscular dysplasia by intravascular ultrasound-guided atherectomy. Nephron. 2002;91(3):521–5.PubMedCrossRef

56.

Gowda MS, et al. Complementary roles of color-flow duplex imaging and intravascular ultrasound in the diagnosis of renal artery fibromuscular dysplasia: should renal arteriography serve as the “gold standard”? J Am Coll Cardiol. 2003;41(8):1305–11.PubMedCrossRef

57.

Jain G, et al. Percutaneous retrograde revascularization of the occluded celiac artery for chronic mesenteric ischemia using intravascular ultrasound guidance. Cardiovasc Interv Ther. 2013;28(3):307–12.PubMedCrossRef

58.

Iwase K, et al. Isolated dissecting aneurysm of the superior mesenteric artery: intravascular ultrasound (IVUS) images. Hepatogastroenterology. 2007;54(76):1161–3.PubMed

59.

Liu R, et al. An optical coherence tomography assessment of stent strut apposition based on the presence of lipid-rich plaque in the carotid artery. J Endovasc Ther. 2015;22(6):942–9.PubMedCrossRef

60.

Chiocchi M, et al. Intravascular ultrasound assisted carotid artery stenting: randomized controlled trial. Preliminary results on 60 patients. J Cardiovasc Med (Hagerstown). 2019;20(4):248–52.CrossRef

61.

Okazaki T, et al. Detection of in-stent protrusion (ISP) by intravascular ultrasound during carotid stenting: usefulness of stent-in-stent placement for ISP. Eur Radiol. 2019;29(1):77–84.PubMedCrossRef

62.

Kotsugi M, et al. Carotid artery stenting: investigation of plaque protrusion incidence and prognosis. JACC Cardiovasc Interv. 2017;10(8):824–31.PubMedCrossRef

63.

Shinozaki N, Ogata N, Ikari Y. Plaque protrusion detected by intravascular ultrasound during carotid artery stenting. J Stroke Cerebrovasc Dis. 2014;23(10):2622–5.PubMedCrossRef

64.

Hong MK, et al. Long-term outcomes of minor plaque prolapsed within stents documented with intravascular ultrasound. Catheter Cardiovasc Interv. 2000;51(1):22–6.PubMedCrossRef

65.

Kono AK, et al. Usefulness of intravascular ultrasonography for treatment of a ruptured vertebral dissecting aneurysm. Radiat Med. 2006;24(8):577–82.PubMedCrossRef

66.

Yoon WK, et al. Intravascular ultrasonography-guided stent angioplasty of an extracranial vertebral artery dissection. J Neurosurg. 2008;109(6):1113–8.PubMedCrossRef

67.

Chung WJ, et al. Clinical impact of intravascular ultrasound guidance during endovascular treatment of subclavian artery disease. J Endovasc Ther. 2017;24(5):731–8.PubMedCrossRef

68.

Chiou AC. Intravascular ultrasound-guided bedside placement of inferior vena cava filters. Semin Vasc Surg. 2006;19(3):150–4.PubMedCrossRef

69.

Hislop S, et al. Correlation of intravascular ultrasound and computed tomography scan measurements for placement of intravascular ultrasound-guided inferior vena cava filters. J Vasc Surg. 2014;59(4):1066–72.PubMedCrossRef

70.

Hodgkiss-Harlow K, et al. Technical factors affecting the accuracy of bedside IVC filter placement using intravascular ultrasound. Vasc Endovasc Surg. 2012;46(4):293–9.CrossRef

71.

Ganguli S, et al. Comparison of inferior vena cava filters placed at the bedside via intravenous ultrasound guidance versus fluoroscopic guidance. Ann Vasc Surg. 2017;39:250–5.PubMedCrossRef

72.

Hager ES, et al. Outcomes of endovascular intervention for May-Thurner syndrome. J Vasc Surg Venous Lymphat Disord. 2013;1(3):270–5.PubMedCrossRef

73.

Raju S, et al. Optimal sizing of iliac vein stents. Phlebology. 2018;33(7):451–7.PubMedCrossRef

74.

Rizvi SA, et al. Stent patency in patients with advanced chronic venous disease and nonthrombotic iliac vein lesions. J Vasc Surg Venous Lymphat Disord. 2018;6(4):457–63.PubMedCrossRef

75.

Shammas NW, et al. Intravascular ultrasound assessment and correlation with angiographic findings demonstrating femoropopliteal arterial dissections post atherectomy: results from the iDissection study. J Invasive Cardiol. 2018;30(7):240–4.PubMed

76.

Schwindt AG, et al. Lower extremity revascularization using optical coherence tomography-guided directional atherectomy: final results of the evaluation of the pantheris optical coherence tomography imaging atherectomy system for use in the peripheral vasculature (VISION) study. J Endovasc Ther. 2017;24(3):355–66.PubMedCrossRef

77.

Kuku KO, et al. Intravascular ultrasound assessment of the effect of laser energy on the arterial wall during the treatment of femoro-popliteal lesions: a CliRpath excimer laser system to enlarge lumen openings (CELLO) registry study. Int J Card Imaging. 2018;34(3):345–52.CrossRef

78.

Babaev A, et al. Orbital atherectomy plaque modification assessment of the femoropopliteal artery via intravascular ultrasound (TRUTH study). Vasc Endovasc Surg. 2015;49(7):188–94.CrossRef

79.

Armstrong EJ, Bishu K, Waldo SW. Endovascular treatment of infrapopliteal peripheral artery disease. Curr Cardiol Rep. 2016;18(4):34.PubMedCrossRef

80.

Reekers JA, Bolia A. Percutaneous intentional extraluminal (subintimal) recanalization: how to do it yourself. Eur J Radiol. 1998;28(3):192–8.PubMedCrossRef

81.

Spinosa DJ, et al. Subintimal arterial flossing with antegrade-retrograde intervention (SAFARI) for subintimal recanalization to treat chronic critical limb ischemia. J Vasc Interv Radiol. 2005;16(1):37–44.PubMedCrossRef

82.

Gandini R, et al. The “Safari” technique to perform difficult subintimal infragenicular vessels. Cardiovasc Intervent Radiol. 2007;30(3):469–73.PubMedCrossRef

83.

Saketkhoo RR, et al. Percutaneous bypass: subintimal recanalization of peripheral occlusive disease with IVUS guided luminal re-entry. Tech Vasc Interv Radiol. 2004;7(1):23–7.PubMedCrossRef

84.

Schaefers JF, et al. Outcome after crossing femoropopliteal chronic total occlusions based on optical coherence tomography guidance. Vasc Endovasc Surg. 2018;52(1):27–33.CrossRef

85.

Baker AC, et al. Technical and early outcomes using ultrasound-guided reentry for chronic total occlusions. Ann Vasc Surg. 2015;29(1):55–62.PubMedCrossRef

86.

Jones DA, et al. Angiography alone versus angiography plus optical coherence tomography to guide percutaneous coronary intervention: outcomes from the Pan-London PCI cohort. JACC Cardiovasc Interv. 2018;11(14):1313–21.PubMedCrossRef

Title: Intravascular Imaging for Peripheral Vascular Disease and Endovascular Intervention
Authors: Eric Rothstein
Herbert Aronow
Beau M. Hawkins
Michael N. Young
Publication date: 01-02-2020
Publisher: Springer US
Keywords: Angiography
Intravascular Ultrasound
Peripheral Arterial Disease
Peripheral Arterial Disease
Published in: Current Cardiovascular Imaging Reports / Issue 2/2020
Print ISSN: 1941-9066
Electronic ISSN: 1941-9074
DOI: https://doi.org/10.1007/s12410-020-9526-0

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