Roberto Gandini MD, PhD, Abstract Co-Author: Nothing to Disclose

Marcello Chiocchi MD, Abstract Co-Author: Nothing to Disclose

Giorgio Loreni, Abstract Co-Author: Nothing to Disclose

Daniele Morosetti MD, Presenter: Nothing to Disclose

Antonio Chiaravalloti MD, Abstract Co-Author: Nothing to Disclose

Giovanni Simonetti MD, Abstract Co-Author: Nothing to Disclose

Primary endpoint was to evaluate the real time ability of IVUS to identify any technical difficulties or complications during stenting and improve outcomes and patency rates. 

Sixty Patients who underwent CAS procedure during a 14-month period, were prospectively evaluated. Thirty Patients (50%) underwent IVUS assisted CAS, 30 Patients (50%) underwent CAS using angiography as unique diagnostic tool. All patients were evaluated through a primary Duplex Ultrasound (DUS) evaluation; as a secondary evaluation fiftyfour patients (90%) underwent a pre-procedural Magnetic Resonance Angiography (MRA), while 6 patients (10 %) underwent Computed Tomography-Angiography (CTA). Patients with preocclusive stenoses (≥ 85%) were excluded. Mean follow-up was 23 months.

No periprocedural or late complications were observed. No statistical significance was experienced in long-term stent patency between the two groups. Mean length of procedural time in IVUS assisted procedures resulted 7 minutes longer than non-ivus assisted procedures. Virtual Histology (VH) - IVUS evaluation of plaque morphology led to a different stent choice in three patients. In one case, the IVUS assessment revealed the suboptimal stent deployment, solved by angioplasty; in one Patient VH-IVUS detected plaque protrusion through stent cells, immediately treated by manual aspiration.

IVUS and Virtual Histology-IVUS has proven to be effective for real-time evaluation of CAS, allowing the Operator to add additional maneuvers in order to improve outcomes and patency rate.

IVUS may be a useful tool for intraprocedural carotid artery stenting results check.

Gandini, R, Chiocchi, M, Loreni, G, Morosetti, D, Chiaravalloti, A, Simonetti, G, Randomized Control Study of the Intravascular Ultrasound vs Angiography for the Evaluation and Treatment of Carotid Artery Stenosis.  Radiological Society of North America 2012 Scientific Assembly and Annual Meeting, November 25 - November 30, 2012 ,Chicago IL. http://archive.rsna.org/2012/12025678.html