Читать книгу Interventional Cardiology - Группа авторов - Страница 228

IVUS provides the potential for reduced contrast volume with an upfront low contrast IVUS‐guided strategy as demonstrated in recent studies zero‐contrast IVUSguided PCI. [56,57]. Efforts are underway to develop noncontrast‐based flush media alternatives for optical coherence tomography (OCT) [58]. IVUS is also important for PCI for chronic total occlusion intervention (see relevant chapter); identifying and crossing the proximal fibrous cap, determining whether the wire and IVUS catheter are in the true or false lumen proximally and distally before stenting to avoid implanting a stent into a false lumen, guiding stent optimization, and assessing complications. IVUS is also the preferred modality to visualize the true lumen especially after guidewire crossing because it avoids hydraulic forces that occur with forceful injection of flush media (i.e. risk to widen the flap if wiring went in the false lumen) with either angiography or OCT.