1. IVUS in Peripheral Procedures
Donald B Reid
Scotland

3. Internal Carotid Artery
intima
media
adventitia
lumen

4. Color Flow IVUS
Irshad K, Reid DB, Miller P et al. J Endovasc Ther 2001; 8:

7. Angiogram Silhouette Cross-section
Additionally, angiography by itself causes ambiguity. These are illustrations of the same lesion as viewed at different angles.. As you can see, in one view the lesion is 75%, in the other 26%. How many times have you seen a physician call for one more picture? This continues for several angles and they still don’t have the answer. This continues until their partner is called for advice and there is still a difference of opinion. This all could have been avoided had IVUS been performed as soon as there was a question surrounding that particular lesion. This in itself is a savings of time and patient exposure to further, unnecessary contrast injections.

8. Clinical use of IVUS Assesses severity of disease
Measures diameters for stent choice
Assesses completeness of treatment
Accuracy of placement

9. Stent Apposition

10. Reid DB, Diethrich EB, Marx P et al 1996
Innominate
Carotid Iliac Subclavian/ Aorta Others
Patients
Procedures
Satisfactory Angio
Sub Optimal on
IVUS (40%) (64%) (11%) (60%) (0%)
Mean % increase % % 10% %
in min stent dia
Reid DB, Diethrich EB, Marx P et al 1996

11. Reid DB, Diethrich EB, Marx P et al 1996

12. Arko F, Buckley C et al. J Vasc Surg 1996 27:614-623
Bibliography
Arko F, Buckley C et al. J Vasc Surg :
Use of intravascular ultrasound improves long-term clinical outcome in the endovascular management of atherosclerotic aorto-iliac occlusive disease

13. Limb Salvage with IVUS 39/50 ( 78% ) avoided major amputation
Average follow up 1 year ( range months )
years
Irshad K. , Rahman N , Bain D et al. 2004

14. 8.4 Fr Aortic Probe

15. Aortic Arch Aneurysm

16. Innominate
Subclavian
Carotid

18. Thoracic Dissecting Aneurysm

19. S, September 2006, Pages 155–162 Diethrich EB, Irshad K & Reid DB
Seminars in Vascular Surgery2006; 19:

20. Subclavian
Carotid
Diethrich EB, Irshad K & Reid DB
Seminars in Vascular Surgery2006; 19:

21. Diethrich EB, Irshad K & Reid DB
Seminars in Vascular Surgery2006; 19:

22. Reid DB, Diethrich EB, Marx P et al. J Endovasc Surg 1996; 3: 203-210
CAROTID IVUS
Reid DB, Diethrich EB, Marx P et al. J Endovasc Surg 1996; 3:

23. Reid DB, Diethrich EB, Marx P et al. J Endovasc Surg 1996; 3: 203-210
CAROTID IVUS
Reid DB, Diethrich EB, Marx P et al. J Endovasc Surg 1996; 3:

24. Virtual Histology IVUS
Calcification
Fibrous Plaque
Fibrofatty Plaque
Necrotic Core Plaque

26. Virtual Histology IVUS
Fibrous Plaque
Irshad K, Velu R, Reid AW et al J Endovasc Ther 2007 ; 14 :

27. Following Reballooning
Irshad K, Velu R, Reid AW et al J Endovasc Ther 2007 ; 14 :

28. Cerebral FilterWire

29. Embolic Material in Filter
Irshad K, Velu R, Reid AW et al J Endovasc Ther 2007 ; 14 :

30. Histopathology and Plaque Progression

31. Thin cap fibroatheroma
Intimal thickening
Thin cap fibroatheroma
Fibroatheroma
Calcified thin cap fibroatheroma
Calcified fibroatheroma
Fibrocalcific

32. Thin cap fibroatheroma
Intimal thickening
Thin cap fibroatheroma
Fibroatheroma
Calcified thin cap fibroatheroma
Calcified fibroatheroma
Fibrocalcific

33. Type of plaque Accuracy
CAPITAL STUDY
Type of plaque Accuracy
Thin cap fibroatheroma %
Calcified thin cap fibroatheroma %
Fibroatheroma %
Fibrocalcic %
Intimal thickening %
Calcified fibroatheroma %
Diethrich EB, Margolis PM, Reid DB et al JEndovasc Ther ; 14 :

34. Calcified Nodules
Diethrich EB, Margolis PM, Reid DB et al JEndovasc Ther ; 14 :

35. CAPITAL STUDY
% Necrotic core
P < 0.05
Aspirin No Aspirin

36. Pioneer Catheter
Al-Ameri H, Shin V, Mayeda G et al. J Invasive Cardiol 2009, 21:

37. Clinical use of IVUS Assesses severity of disease
Measures diameters for stent choice
Assesses completeness of treatment
Accuracy of placement