Current use of intravascular ultrasound in coronary artery disease

Recently, most coronary interventions rely on visual assessment of the coronary lesions using angiography with all known inherent limitations. Intravascular ultrasound (IVUS) allows for the evaluation of the coronary pathology to obtain information about both the extent and nature of atherosclerotic plaque; thus, planning the intervention strategy is based on objective data. Following the advent of gray-scale IVUS, several modes had been developed to study coronary plaque composition, thus determining the predominant component of the plaque, fibrous tissue, lipid-necrotic core, or calcium, and the intervention strategy. After intervention, IVUS plays an important role in optimizing the results after stent deployment regarding stent expansion and apposition to reduce the incidence of both stent thrombosis and in-stent restenosis. This review discusses the basic role of IVUS in evaluating plaque structure and parameters to optimize results after coronary intervention in light of recent evidence.