Читать книгу Interventional Cardiology - Группа авторов - Страница 223

Pre‐interventional IVUS is performed to assess stenosis severity and plaque composition and distribution, measure reference vessel size, and measure lesion length. As a result, stent size can be chosen more accurately than solely by angiography. There are a number of paradigms that can be used. Stent size can be selected by identifying the maximum reference lumen diameter (proximal or distal to the lesion); it results in stent upsizing without an increase in complications. At the other extreme, stents can be sized to the “true vessel,” “media‐to‐media,” or mid‐wall dimensions to reflect the amount of angiographically silent disease and, in most cases, the extent of positive remodeling, not just vessel size. Typically, this measurement will be larger than reference lumen reference and, thus, should be used only by experienced operators who understand its limitations.

IVUS measures lesion length more accurately than angiography because IVUS eliminates foreshortening, vessel tortuosity, or bend points.