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Sivashanmugam S: IVUS – Seeing Beyond Angiography
Sivashanmugam S
Mar 25, 2026, 14:40

Sivashanmugam S: IVUS – Seeing Beyond Angiography

Sivashanmugam S, Staff Registered Nurse at Rela Hospital, shared a post on LinkedIn:

”Intravascular Ultrasound (IVUS): Seeing Beyond Angiography

Intravascular Ultrasound (IVUS) is an advanced intracoronary imaging modality that provides real-time, cross-sectional images of coronary arteries, helping optimize diagnosis and PCI outcomes.

What is IVUS?

IVUS uses a miniature ultrasound probe mounted on a catheter to visualize the arterial wall, lumen, and plaque morphology from inside the vessel.

Why IVUS?

Unlike angiography (2D lumen view), IVUS provides:

  • 360° vessel visualization
  • Accurate lesion assessment
  • Precise vessel sizing
  • Detection of plaque characteristics (calcified, fibrous, lipid-rich)

Indications

  • Assessment of ambiguous/intermediate lesions
  • Left main coronary artery disease
  • Optimization of stent sizing and deployment
  • Evaluation of stent thrombosis or restenosis
  • Guidance in complex PCI

Equipment Used

  • IVUS console system
  • IVUS catheter
  • Guiding catheter
  • Pullback device (manual/automatic)
  • Heparinized saline flush

Procedure Steps

  • Vascular Access (Radial/Femoral)
  • Guide Catheter Engagement
  • Guidewire Placement
  • IVUS Catheter Advancement
  • Image Acquisition (manual/auto pullback)
  • Lesion Analysis and Measurements
  • PCI Optimization (if required)

Key Measurements

  • Lumen Area (MLA)
  • Vessel Diameter
  • Plaque Burden (%)
  • Stent Expansion & Apposition

Complications

  • Coronary spasm
  • Dissection (rare)
  • Arrhythmias
  • Catheter-related issues

Key Nursing Responsibilities

  • Prepare IVUS console and catheter
  • Maintain sterile field
  • Continuous ECG and hemodynamic monitoring
  • Assist during catheter insertion and pullback
  • Ensure proper flushing to avoid artifacts

Key Takeaway

IVUS enhances precision in PCI by guiding stent selection, ensuring optimal deployment, and reducing complications—leading to better long-term outcomes.”

Sivashanmugam S: IVUS - Seeing Beyond Angiography

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