Intracoronary ultrasound imaging: Methods and clinical applications

OBJECTIVE: To review the development of intracoronary ultrasound, its curre nt utility and the impetus for its continued development as a coronary imag ing modality. DATA SOURCES: English language literature (1966 to 1999) was searched in th e MEDLINE database with the key words 'ultrasound', 'intravascular' and 'in tracoronary', and limited to human studies. In addition, an online public a ccess catalogue was searched using the subject headings 'cardiovascular dis eases therapy','heart diseases' and 'vascular diseases'. STUDY SELECTION AND DATA EXTRACTION: Articles relating to the history of in travascular or intracoronary ultrasound, methods and materials employed, ad vantages and disadvantages, safety issues and future directions of research in the area of intracoronary ultrasound were selected. DATA SYNTHESIS: Intracoronary ultrasound has been shown to improve upon dem onstrated weaknesses of coronary angiography This imaging technique, while invasive, has not been associated with significant, acute adverse effects a nd has proved to be useful in guiding interventions, and evaluating the mec hanism and extent of their success. Technological limitations with respect to the equipment employed, and the acquisition, processing and display of i mages are the subject of intense research focus because they hinder more wi despread clinical use of intracoronary ultrasound. CONCLUSIONS: Intracoronary ultrasound has emerged as a safe and useful tool in the visualization of the coronary vasculature. Technological limitation s and questions about long term safety are a concern. Its ability to overco me the inherent limitations of coronary angiography, and to guide and evalu ate coronary interventions supports the notion that this technique will con tinue to assume an ever-expanding role in interventional cardiology.