JOURNAL TOOLS |
Publishing options |
eTOC |
To subscribe |
Submit an article |
Recommend to your librarian |
ARTICLE TOOLS |
Publication history |
Reprints |
Permissions |
Cite this article as |
Share |
YOUR ACCOUNT
YOUR ORDERS
SHOPPING BASKET
Items: 0
Total amount: € 0,00
HOW TO ORDER
YOUR SUBSCRIPTIONS
YOUR ARTICLES
YOUR EBOOKS
COUPON
ACCESSIBILITY
REVIEW Free access
International Angiology 2017 December;36(6):505-16
DOI: 10.23736/S0392-9590.17.03866-4
Copyright © 2017 EDIZIONI MINERVA MEDICA
language: English
The role of intravascular ultrasound in lower limb revascularization in patients with peripheral arterial disease
Gregory C. MAKRIS 1, 2 ✉, Pavlina CHRYSAFI 3, Mark LITTLE 1, Rafiuddin PATEL 1, Mark BRATBY 1, Andrew WIGHAM 1, Susan ANTHONY 1, Raman UBEROI 1
1 Department of Vascular and Interventional Radiology, Oxford University Hospitals, NHS Foundation Trust, Oxford, UK; 2 Alfa Institute of Biomedical Sciences, Athens, Greece; 3 School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
INTRODUCTION: The aim of this review is to explore the safety and effectiveness of intravascular ultrasound (IVUS) during lower limb endovascular interventions in patients with peripheral arterial disease (PAD).
EVIDENCE ACQUISITION: A systematic review of the PubMed and Scopus databases was performed according to PRISMA guidelines. Clinical studies evaluating IVUS as an adjunct to angiography during revascularization procedures in patients with PAD were included.
EVIDENCE SYNTHESIS: Thirteen studies were identified, with a total number of 2258 patients having had IVUS for PAD intervention. Seven investigated the role of IVUS for angioplasty and stenting, with the majority being retrospective cohorts. Technical success and patency rates ranged from 90-100% and 45-100%, respectively, with a follow-up that ranged from 4.3-63 months. Three of these studies compared IVUS and non-IVUS guided angioplasty and demonstrated a significant difference in the events of amputations or re-interventions in favor of the IVUS group. Furthermore, five studies evaluated IVUS use in true-lumen re-entry, with the technical success ranging between 97-100%. In one study, where IVUS was used for atherectomy, the technical success was 100% and the long-term patency was 90% during a 12-month follow-up. Overall, no significant peri/postoperative IVUS related complications were reported, whereas, 2 studies suggested an IVUS-associated increase in procedure costs that ranged from $1080-$1333.
CONCLUSIONS: There is limited and heterogeneous evidence regarding the use of IVUS for the management of PAD. Further research is required to elucidate the optimal role of IVUS in PAD as well as the cost effectiveness of this approach for routine use in the management of PAD.
KEY WORDS: Ultrasonography, interventional - Peripheral arterial disease - Angioplasty