Читать книгу Interventional Cardiology - Группа авторов - Страница 212

Two important consensus documents have been published: Clinical use of intracoronary imaging. Part 1: guidance and optimization of coronary interventions. An expert consensus document of the European Association of Percutaneous Cardiovascular Interventions [4] and the Clinical use of intracoronary imaging. Part 2: acute coronary syndromes, ambiguous coronary angiography findings, and guiding interventional decision‐making: an expert consensus document of the European Association of Percutaneous Cardiovascular Interventions [5].

IVUS is displayed as a tomographic cross‐sectional view. A longitudinal view (L‐mode or long‐view) can be also displayed, but this should be done only when using motorized transducer pullback. Longitudinal representation of IVUS images is useful for lengths measurements, for interpolation of shadowed deep arterial structures (i.e. external elastic membrane behind calcium or stent metal). There are advantages and disadvantages to using manual or motorized pullback; however, motorized pullback is usually preferable. Using motorized transducer pullback allows assessment of lesion length, volumetric measurements, consistent and systematic IVUS image acquisition among different operators, and uniform and reproducible image acquisition for multicenter and serial studies.

In standard image acquisition after anticoagulation and intracoronary nitroglycerin administration, the IVUS catheter should be placed distal to the segment of interest (aiming for 20 mm of distal reference), and a continuous pullback to the aorta should be recorded. The preferred pullback speed is 0.5 mm/s but 1 mm/s is often used.