Intravascular Ultrasound Imaging-Guided Percutaneous Coronary Intervention: Evidence and Practical Implications

Intravascular ultrasound (IVUS) has significantly advanced the field of percutaneous coronary intervention (PCI), offering enhanced visualization and assessment capabilities that surpass traditional angiography. IVUS technology generates images from reflected ultrasound waves, providing critical insights into plaque characteristics, vessel size, and lesion morphology. These capabilities facilitate precise stent placement, optimal sizing, and the identification of features associated with stent failure, such as underexpansion and malapposition. Studies have demonstrated that IVUS-guided PCI significantly reduces major adverse cardiovascular events and improves long-term outcomes, particularly in complex lesions. This comprehensive review outlines the technical nuances, evidence, and clinical applications of IVUS.