《intravascular ultrasound》.pdf

May 2008 Harvard Medical Beth Israel Deaconess Harvard Medical Beth Israel Deaconess School Medical Center School Medical Center Intravascular Ultrasound Matthew Altman, HMS III Gillian Lieberman, MD BIDMC Department of Radiology Presentation Overview 1. Patient presentation, RG 2. Overview of intravascular ultrasound (IVUS) 3. Patient RG workup, diagnosis, and treatment 4. Utility and clinical indications of IVUS 5. Research uses of IVUS 6. Recent advancements and future directions of IVUS 7. Summary Patient RG • RG is a 73 year old gentleman with classic angina on exertion. • Coronary angiography at an outside hospital showed significant coronary lesions in the left anterior descending (LAD), left circumflex (LCx), and elsewhere. • There was a question of a left main coronary artery (LMCA) lesion in the left coronary ostium but it could not be adequately visualized by angiography. • He was referred to the Beth Israel Deaconess Medical Center (BIDMC) for possible coronary artery bypass grafting (CABG) versus percutaneous coronary intervention (PCI). Our patient RG: Left coronary artery branches on coronary angiogram LCx LAD Green arrows demonstrate luminal narrowings in the LAD and LCx. Image courtesy of New England Baptist Hospital Our patient RG: Additional view of left coronary artery branches on coronary angiogram LCx Green arrow demonstrates a luminal narrowing in the LCx.