Intravascular Ultrasound

How does Intravascular Ultrasound quantify Plaque?

Intravascular ultrasound (IVUS) is used to view the insides of coronary arteries and quantify arterial plaque.

IVUS is an invasive diagnostic test. It combines echocardiography with cardiac catheterization and is also known as intravascular echocardiography. It is frequently done together with a percutaneous coronary intervention, such as angioplasty, to treat coronary artery disease.

How to Prevent Arterial Plaque Ruptures

What is arterial Plaque?

Arterial plaque is made up of materials that enter the artery wall from the bloodstream. These include cholesterol, fat, calcium, waste products from cells, and a clotting agent called fibrin.  (Image credit)

As it builds up, plaque may cause the arterial internal rupture, allowing a blood clot to form. Arterial clots (thrombosis) can block local blood flow completely, or they may break free and cause dangerous blockages elsewhere.

How is Intravascular Ultrasound performed?

The patient is often asked to don a hospital gown and lie down on the procedure table. An IV (intravenous) line is connected to his arm, and a mild sedative is administered to aid in relaxation. Some patients may also require general anesthesia. The groin area is cleaned (where the catheter will be inserted). The Groin area is shaved, cleaned, and covered with a surgical drape. The technician then anesthetizes and inserts a sheath into the artery or vein at the puncture site. 

The catheter is guided into the coronary artery via the sheath and threaded to the target site through the blood vessel. This is done with the help of ultrasound guidance or x-ray. On reaching the target site, the transducer located at the end of the catheter emits sound waves. These waves are then bounced off by the artery walls and received by the transducer as echoes. A monitor finally converts the echoes to images to produce pictures of the inside of the blood vessels. The catheter can be moved to capture the images of the vessels at different sites. When the technician completes the procedure, he removes the catheter. It stops the bleeding at the puncture site by applying pressure. Sometimes, a closure device may be used to control the bleeding.   

Are there any risks involved in it? :

The risks associated with this test are arrhythmia, blood clots, kidney failure, and allergic reactions to the medications used during IVUS. Some rare complications that may arise due to an IVUS are heart attack, stroke, and blood clots in the lung.

Read about how to diagnose heart disorders

FAQs: Intravascular Ultrasound

What are preparations required from the patient? The patient is generally advised to wear loose and comfortable clothing to the test. He/She is asked to remove all jewelry and metal objects before the test. Suppose the patient is diabetic or has kidney disease. In that case, it must be specifically mentioned to the doctor before the test.

How long does it take? IVUS might take less than an hour to several hours to complete.  

Who performs it? Interventional cardiologists perform this test in a cardiac catheterization lab or interventional radiology suite.

How much does Intravascular Ultrasound cost? It costs around Rs. 40K to 50K to do an IVUS.

When can I go home after the procedure? After the test, the patient is asked to lie down for about 2 to 6 hours to prevent bleeding. If the test is done together with angioplasty, the patient will be required to stay in the hospital for 12 to 24 hours. After this period, he is allowed to go home.

References:

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