Douglas M. Cavaye, FRACS, Rodney A. White, MD, George E

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Three-dimensional intravascular ultrasound imaging of normal and diseased canine and human arteries  Douglas M. Cavaye, FRACS, Rodney A. White, MD, George E. Kopchok, MD, Mark P. Mueller, MD, Michael J. Maselly, MD, Marwan R. Tabbara, MD  Journal of Vascular Surgery  Volume 16, Issue 4, Pages 509-519 (October 1992) DOI: 10.1016/0741-5214(92)90158-5 Copyright © 1992 Society for Vascular Surgery and the North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 1 A, Comparison of angiography and IVUS in common and external iliac arteries. Center panels represent right iliac arteriogram with high-contrast volume (upper) and low-contrast volume (lower). Cross-sectional IVUS images A through F correspond to sites on arteriograms identified by same letters. Note trilaminar appearance in relatively normal segments of muscular artery wall (arrows) produced by differing echoic properties of intima, media, and adventitia. Hypoechoic media (arrows), soft plaque (s), and calcified plaque (c) are seen. Artifact (a) is produced by transducer wires crossing ultrasound catheter mirror assembly and allows rotational orientation of images. Ultrasound catheter is represented by black circle in lumen of each image. B, Longitudinal section of reconstructed iliac artery segment displayed in panel A. Ultrasound catheter (u) is surrounded by blood (b) of density similar to that of portions of arterial wall. Media (arrows) is highlighted as hypoechoic layer between hyperechoic intima and adventitia. Fibrous plaque (f) appears as bright hyperechoic lesion and calcified plaque (c) produces dense acoustic shadows beyond lesion. Journal of Vascular Surgery 1992 16, 509-519DOI: (10.1016/0741-5214(92)90158-5) Copyright © 1992 Society for Vascular Surgery and the North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 2 A, Longitudinal gray-scale section of three-dimensional reconstruction of atheromatous human superficial femoral artery shows hypoechoic media (arrows) and distribution and type of plaque (s, soft; c, calcified). The 5F (1.66 mm diameter) ultrasound catheter artifact (u) acts as scale to allow measurement of vessel dimensions. B, Three-dimensional image of arterial segment shows topography of luminal surface and image dropout at site of maximal calcific stenosis (c) caused by ultrasound signal attenuation. Cylindric, smooth surface of the lumen on left side of image (double arrows) occurs where IVUS catheter is impacted within stenosis. Media is easily visualized (single arrows). Journal of Vascular Surgery 1992 16, 509-519DOI: (10.1016/0741-5214(92)90158-5) Copyright © 1992 Society for Vascular Surgery and the North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 3 A, Longitudinal gray-scale image of canine acute aortic dissection entry point, with blood flowing from proximal (right) to distal (left). Aortic walls (arrows), dissection flap (F), and true (t) and false (f) lumens are visualized. B, Three-dimensional reconstruction of distal portion of canine aortic dissection shows dissection flap (F) finishing at end point of dissection. Left renal artery orifice (o) is seen behind flap, and by rotating image on screen its relationship to true (t) and false (f) lumens could be determined. Journal of Vascular Surgery 1992 16, 509-519DOI: (10.1016/0741-5214(92)90158-5) Copyright © 1992 Society for Vascular Surgery and the North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 4 A, Three-dimensional image of stented soft heterogenous canine iliac artery lesion (L). Stent structure (arrows) can be seen conforming to luminal contour, confirming satisfactory deployment. IVUS catheter transducer wire artifact (a) can be removed from images by more recent software developments. B, Three-dimensional image of stented canine aortic dissection shows residual false lumen (F) and “woven” texture of expanded stent (double arrows). Single arrows identify bright echoes produced by stent struts. Journal of Vascular Surgery 1992 16, 509-519DOI: (10.1016/0741-5214(92)90158-5) Copyright © 1992 Society for Vascular Surgery and the North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions

Fig. 5 Three-dimensional images of human aortic dissection with computer software from mid-1990 (A) and late 1991 (B). Computer processing time of 80 minutes was required to produce image A, whereas more recent, better resolution image (B) was produced in 16 seconds. Dissection flap (arrows) can be seen separating false (F) and true (T) lumina, with the IVUS catheter artifact (u) surrounded by hyperechoic blood (b) in A. In B blood signals have been removed electronically before reconstruction. Journal of Vascular Surgery 1992 16, 509-519DOI: (10.1016/0741-5214(92)90158-5) Copyright © 1992 Society for Vascular Surgery and the North American Chapter, International Society for Cardiovascular Surgery Terms and Conditions