Intravascular Ultrasound

What is intravascular ultrasound?

Intravascular ultrasound (IVUS) uses sound waves to assess soft tissue. Tiny instruments capture real-time images from inside your blood vessels. Intravascular ultrasound often evaluates arteries and veins near the heart (coronary arteries). It can also test other blood vessels.

The procedure is also known as:

• Coronary intravascular ultrasound.
• Endovascular ultrasound.
• Intravascular echocardiography.

How does intravascular ultrasound work?

IVUS uses a tiny tube (catheter) to access and evaluate blood vessel tissue. A healthcare provider advances the catheter through an incision, typically in the groin, to reach the assessment area.

The catheter has an ultrasound probe at the tip that emits high-frequency sound waves. The sound waves bounce off blood vessel walls, creating echoes. A computer converts the sound waves into real-time images.

How can an intravascular ultrasound procedure help me?

You may benefit from IVUS if healthcare providers suspect blood vessel narrowing or blockages. The procedure can help you manage life-threatening conditions that include:

• Heart attack.
• Pulmonary embolism.
• Stroke.

IVUS helps healthcare providers:

• Assess the severity of plaque buildup inside arteries (atherosclerosis) and potential blockages.
• Determine whether you need additional procedures, such as coronary artery bypass surgery.
• Plan and deliver treatments. These may include a hollow mesh device (stent) to keep the blood vessel open.

How will I know if intravascular ultrasound is right for me?

Your healthcare provider may recommend IVUS if you have symptoms of or are at risk for:

• Aortic aneurysm.
• Blood clots.
• Carotid artery disease.
• Coronary artery disease.
• Deep vein thrombosis (DVT).
• Peripheral artery disease (PAD).
• Pulmonary artery stenosis.

How is coronary intravascular ultrasound different from angiography?

Angiography also captures images from inside the blood vessels. It uses X-rays to create two-dimensional silhouettes of the coronary arteries. IVUS uses sound waves and produces cross-sectional images like slices of bread.

How is an intravascular ultrasound performed?

If your healthcare provider is assessing coronary arteries, IVUS is typically performed as part of cardiac catheterization. This procedure uses a catheter to test heart function. Combining the two tests makes it possible to check additional aspects of heart health in one procedure.

If the assessment area is not near your heart, intravascular ultrasound is a standalone procedure. It’s often used to check for blood clots in veins and PAD in lower leg arteries.

Who performs intravascular ultrasound?

An interventional cardiologist or vascular surgeon performs this procedure.

What happens during an intravascular ultrasound procedure?

Here’s what happens during the procedure:

1. You lie on a table and receive medication (sedative) to help you relax. You may be awake and conscious but will not feel discomfort during the procedure.
2. A healthcare provider cleans the skin near the incision site. They then inject medication (anesthetic) to numb the area.
3. The interventional cardiologist or vascular surgeon slides a plastic sheath into the incision. This makes it easier to insert and advance the catheter.
4. Once the catheter reaches the correct spot, they use the ultrasound probe to capture images.
5. When the procedure is complete, the healthcare provider removes the catheter and sheath.
6. Stitches are typically not necessary to close the incision. A surgical dressing is applied to prevent infection.

How quickly will I receive the results of my IVUS?

This test provides results in real-time. However, your healthcare provider typically waits until after the procedure to discuss them with you. You may receive this information while in the recovery room after the sedative wears off.

What is recovery from an intravascular ultrasound procedure like?

If you have standalone IVUS, you will likely go home the same day. For a coronary intravascular ultrasound, you may need to stay in the hospital overnight.

What are the benefits of IVUS?

IVUS enables healthcare providers to detect blood vessel narrowing and blockages in a timely manner.

Additional benefits include:

• A high degree of accuracy.
• No radiation exposure because the test doesn’t use X-rays.
• Quick results and recovery.

What are the risks of this procedure?

As with any procedure, intravascular ultrasound comes with some risks. They include:

• Arrhythmia (in coronary intravascular ultrasound patients).
• Blood clots.
• Infection at the incision site.
• Dissection or damage to the vessels.

A note from Cleveland Clinic

IVUS is a procedure that uses sound waves to perform comprehensive blood vessel assessments. You may benefit from this type of test if you have or are at risk for blood vessel narrowing or blockages. The procedure helps healthcare providers pinpoint potential problem areas and determine their severity. This information can lower your risk of a life-threatening complication.