IVUS 血管内超声基础和临床应用.ppt

IVUS 培训 Reference Lesion 10 mm Lumen CSA = 18.3mm2 Lumen diameter = 5.0mm Lumen CSA = 3.6mm2 Lumen diameter = 1.3mm Lumen CSA = 11.9mm2 Lumen diameter = 3.5mm Patient with normal ostial LMCA who previously underwent CABG for presumed LMCA disease Patient with severe, but unrecognized, distal LMCA stenosis who was referred for PTCA of LAD Suggested IVUS Criteria for a ‘Significant’ LMCA Stenosis Most IVUS LMCA studies show either insignificant disease or critical disease, only a minority require careful quantification Lumen CSA 6.0mm2 or MLD 3.0mm are suggested criteria for a significant LMCA stenosis The sum of the lumen areas of the two daughter vessels (LAD and LCX, each of which should be 4.0mm2) = 150% of the parent (LM) These correlated with an abnormal FFR (Jasti et al Circulation 2004;110:2831-6) IVUS 培训 IVUS 培训 Unusual Lesions: IVUS Classification of Angiographic Aneurysms Of 77 angiographic aneurysms 21 (27%) true aneurysm 3 (4%) pseudoaneurysm 12 (16%) complex plaques or unhealed dissections 41 (53%) normal segment adjacent to one or more stenoses TrueAneurysm PSA ComplexPlaque Normal Site withAdjacent Stenoses No prior PCI 10 0 6 26 Prior PCI 11 3 6 15 (Maehara et al. Am J Cardiol 2001;88:365-70) 0 18mm Normal Segment with Adjacent Stenoses True Aneurysm High frequency sound waves echo off vessel walls and are sent back to system System electronics process the signal The CardiovascularResearch Foundation Lenox Hill Heart and VascularInstitute of New York IVUS 培训 A L A = Axial Resolution L= Lateral Resolution The CardiovascularResearch Foundation Lenox Hill Heart