See clearly.
Treat optimally.

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IVUS interpretation

Clinical evidence

Advanced imaging

Peripheral IVUS

Angiography alone is not enough in PCI

Angiography provides information on luminal characteristics of vessels, but does not provide a clear picture of the vessel and disease.

However, with IVUS guidance you can see more clearly and improve patient outcomes with informed pre-stent planning and post-stent optimization.¹

74%

of the time, IVUS use resulted in a change in PCI strategy^2,3,4,5

46%

Reduction in TVF at 1 year when IVUS was used^6,7

43%

Lower risk of cardiac death associated with IVUS⁸

See more clinical evidence

Plan, land and expand stents optimally

Learn how Dr. Kerrigan defines stent optimization

Enable improved outcomes and fewer complications. The treatment of coronary lesions with DES is complicated by the challenges of suboptimal post stent results, such as stent under expansion, incomplete stent apposition, edge dissection and geographic miss, which may contribute to increased risk of stent failure.

Learn more about IVUS

See clearly and treat optimally with IVUS in a variety of clinical scenarios

Left main

IVUS is an AHA/ACC/SCAI Class IIa recommendation for the assessment of angiographically indeterminant left main CAD.⁹

IVUS may help to determine:

• Lesion significance

• Vessel sizing

• Optimal stent deployment
Ostial and bifurcation lesions

IVUS guidance reduced long-term all-cause mortality by 76%.¹⁰

IVUS may help to determine:

• Location of the true ostium to decrease risk of geographic miss

• Plaque distribution

• Whether two stents are needed

• Lesion length

• Landing zones

• Whether post-dilation is needed (especially at the proximal stent)
Diffuse disease

Using IVUS for long lesions (stents ≥ 28mm) was associated with a 47% reduction in MACE from 1 to 5 years in the IVUS-XPL randomized control trial.¹¹

IVUS may help to determine:

• Vessel size and length of disease

• Positive remodeling

• Plaque burden

• Stenosis
Repeat patients

IVUS is an AHA/ACC/SCAI Class IIa recommendation to determine the mechanism of stent restenosis.⁹

IVUS may help to determine:

• Extent and mechanism of restenosis for optimal treatment strategy and for the decrease of risk of geographic miss

• Location and amount of thrombus
Ambiguous angiogram

IVUS guidance was associated with less contrast: 20 ml vs. 64.5 ml, p<.001, n=83 patients randomized to IVUS or angiographyguided PCI.¹²

IVUS may help to determine:

• Pathology at the ambiguous site to optimize your treatment strategy

• Device utilization without additional radiation and contrast

See clearly and treat optimally with IVUS in a variety of clinical scenarios

Left main

Ostial & bifurcation lesions

Diffuse disease

Repeat patients

Ambiguous angio

Left main

IVUS is an AHA/ACC/SCAI Class IIa recommendation for the assessment of angiographically indeterminant left main CAD.⁹

IVUS may help to determine:

• Lesion significance

• Vessel sizing

• Optimal stent deployment

Learn about the other clinical scenarios benefited with IVUS

Ostial and bifurcation lesions

IVUS guidance reduced long-term all-cause mortality by 76%.¹⁰

IVUS may help to determine:

• Location of the true ostium to decrease risk of geographic miss

• Plaque distribution

• Whether two stents are needed

• Lesion length

• Landing zones

• Whether post-dilation is needed (especially at the proximal stent)

Learn about the other clinical scenarios benefited with IVUS

Diffuse disease

Using IVUS for long lesions (stents ≥ 28mm) was associated with a 47% reduction in MACE from 1 to 5 years in the IVUS-XPL randomized control trial.¹¹

IVUS may help to determine:

• Vessel size and length of disease

• Positive remodeling

• Plaque burden

• Stenosis

Learn about the other clinical scenarios benefited with IVUS

Repeat patients

IVUS is an AHA/ACC/SCAI Class IIa recommendation to determine the mechanism of stent restenosis.⁹

IVUS may help to determine:

• Extent and mechanism of restenosis for optimal treatment strategy and for the decrease of risk of geographic miss

• Location and amount of thrombus

Learn about the other clinical scenarios benefited with IVUS

Ambiguous angiogram

IVUS guidance was associated with less contrast: 20 ml vs. 64.5 ml, p<.001, n=83 patients randomized to IVUS or angiographyguided PCI.¹²

IVUS may help to determine:

• Pathology at the ambiguous site to optimize your treatment strategy

• Device utilization without additional radiation and contrast

Learn about the other clinical scenarios benefited with IVUS

IVUS interpretation insights

IVUS imaging helps you visualize the best path forward. Dive deeper to understand how IVUS imaging works and how to easily interpret vessel morphologies in common clinical scenarios.

Quickly interpret IVUS images

Interventional excellence

Imaging, physiology, co-registration* and software come together to simplify complex interventions, speed routine procedures and provide improved patient care.

Learn more about IntraSight

Get advanced insight from your pullback

Experience the advanced imaging insights from Philips ChromaFlo and IVUS Co-registration and improve your treatment strategies.

Learn more about ChromaFlo and IVUS Co-registration

Coronary IVUS catheters

Eagle Eye Platinum

Eagle Eye Platinum ST

Refinity ST

IVUS apps designed for interventional cardiologists

Check out the IVUS App for interactive workflow and image interpretation practice

Learn IVUS virtually with the Cardio Ex app

Philips ELIITE Academy is focused on delivering high value and real-time strategic educational programs that meet the evolving needs of our customers. For more information on the available courses, please visit www.igtdacademy.philips.com.

Key thought leaders

Clinical expertise

Product knowledge

Reimbursement and coding resources

Learn more about your reimbursement options

* Co-registration tools available within IntraSight 7 configuration via SyncVision

1. A. Maehara, M. Matsumura, Z.A. Ali, G.S. Mintz, G.W. Stone. IVUS-guided versus OCT-guided coronary stent implantation. J Am Coll Cardiol Img, 10 (2017), pp. 1487- 1503

2. Elgendy IY et al. Outcomes with intravascular ultrasound-guided stent implantation: a meta-analysis of randomized trials in the era of drug eluting stents. Circ-Cardiovasc Interv.2016;9:e003700

3. Ahn JM, Kang SJ, Yoon SH, et al. Meta-analysis of outcomes after intravascular ultrasound-guided versus angiography-guided drug-eluting stent implantation in 26,503 patients enrolled in three randomized trials and 14 observational studies. Am J Cardiol. 2014;113:1338-1347. Hyperlink “http://www.ajconline.org/article/S0002-9149(14)00549-9/abstract”

4. Witzenbichler B, et al. Relationship between intravascular ultrasound guidance and clinical outcomes after drug-eluting stents: The ADAPT-DES study. Circulation. 2014 Jan:129,4;463-470.

5. Singh V, Badheka AO, Arora S, et al. Comparison of in-hospital mortality, length of hospitalization, costs, and vascular complications of percutaneous coronary interventions guided by ultrasound versus guided by angiography. Am J Cardiol. Online 18 Feb 2015.

6. TVF categorized as cardiac death, target vessel MI, and clinical driven TVR

7. Zhang J et al. The ULTIMATE trial. Journal of the American College of Cardiology (2018), doi.org/10.1016/j.jacc.2018.09.013. , accepted September 13 2018.

8. Choi K, et al. Impact of Intravascular Ultrasound-Guided Percutaneous Coronary Intervention on Long-Term Clinical Outcomes in Patients Undergoing Complex Procedures. JACC: Cardivascular Interventions. Mar 2019, 4281; DOI: 10.1016/j.jcin.2019.01.227

9. Levine et al. 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: 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. Circulation 2011;124:e574-651]

10. Kim S, Kim Y, et al. Long-term outcomes of intravascular ultrasound-guided stenting in coronary bifurcation lesions. Am J Cardiol. 2010;106(5):612-8]

11. Hong S-J, et al. “Effect of Intravascular Ultrasound-guided Drug-Eluting Stent Implantation: Five-Year Follow-Up of the IVUS-XPL Randomized Trial, JACC: Cardiovascular Interventions (2019), doi: https://doi.org/10.1016/j.jcin.2019.09.033

12. Mariani et al. MOZART study. JACC Interventions 2014; 7:1287-93.

See clearly. Treat optimally.

Contact information

IVUS interpretation

Angiography alone is not enough in PCI

74%

46%

43%

Plan, land and expand stents optimally