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Intravascular
ultrasound (IVUS)
Definition:
An invasive procedure,
performed along with cardiac catheterization; a miniature sound probe
(transducer) on the tip of a coronary catheter is threaded through the
coronary arteries and, using high-frequency sound waves, produces detailed
images of the interior walls of the arteries.
Your doctor uses IVUS
to:
- view
the artery — from the inside out,
making it possible to evaluate the amount of disease present, how it
is distributed, and in some cases, what it is made of
- determine the need
for further treatment (angioplasty or bypass surgery)
- determine the need
for aggressive management of risk factors prior to onset of symptoms
and advanced disease
- determine the predictors
of transplant coronary artery disease
To prepare:
- You can wear
whatever you like to the hospital. You will wear a hospital gown during
the procedure.
- Some procedures
may require an overnight stay. Leave all valuables at home. If you normally
wear dentures, glasses or a hearing assist device, plan to wear them
during the procedure.
- Your doctor
or nurse will give you specific instructions about what you can and
cannot eat or drink before the procedure.
- Ask your doctor
what medications should be taken on the day of your test. You may be
told to stop certain medications, such as Coumadin (warfarin, a blood
thinner) or aspirin.
- If
you are diabetic,
ask your physician how to adjust your medications the day of your test.
- Tell your doctor
and/or nurses if you are allergic to anything, especially iodine, shellfish,
x-ray dye, latex or rubber products (such as rubber gloves or balloons),
or penicillin-type medications.
- When you are able
to return home, arrange for a companion to bring you home.
What to expect:
- You will be given
a hospital gown to wear.
- A nurse will start
an intravenous (IV) line in your arm so that medications can be administered
during the procedure.
 You
will lie on a special table. The nurse will clean your skin at the groin.
Sterile drapes are used to cover the site and help prevent infection.
It is important that you keep your arms and hands down at your sides
and not disturb the drapes. - Electrodes (small,
flat, sticky patches) will be placed on your chest. The electrodes are
attached to an electrocardiograph monitor (ECG), which charts your heart’s
electrical activity.
- You will be given
a mild sedative to relax you, but you will be awake and conscious during
the entire procedure.
- The doctor will
use a local anesthetic to numb your groin site. A plastic introducer
sheath (short, hollow tube through which the catheter is placed) is
inserted in the groin. A catheter (narrow plastic tube) will be inserted
through the sheath and threaded to the arteries of your heart. Through
the catheter, a wire with an ultrasound tip will be passed into your
coronary arteries.
- Once the catheter
is within the coronary artery, a series of cross-sectional pictures
of the artery are produced.
- Please tell the
doctor or nurses if you feel chest discomfort or any other symptoms
during the procedure.
The IVUS procedure
takes about 60 minutes.
Click
here to learn more about the cardiac catheterization procedure.
After the procedure:
- The catheters and
sheath are removed. Pressure will be placed on leg artery. You will
need to lie flat and keep the leg straight for three to six hours to
prevent bleeding. A pressure dressing will be applied tightly on the
groin. The nurse will check your bandage regularly, but call your nurse
if you think you are bleeding (have a wet, warm sensation) or if your
toes begin to tingle or feel numb.
- You may be admitted
overnight for observation. You will need to be on bedrest for several
hours. The nurse will remove the pressure dressing the morning following
your procedure.
- Your doctor will
tell you if you are able to return home or should stay for further treatment.
Treatment, including medications and diet, will be discussed with you
prior to going home. Care of the wound site, activity and follow-up
care will also be discussed.
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Dr. Nissen reviewing an IVUS
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Please ask your doctor
if you have any questions about IVUS.
Click here to:
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