Intravascular ultrasound (IVUS)

An intravascular ultrasound is an imaging test that creates images of the heart and blood vessels from the inside of the body. An interventional cardiologist inserts a catheter with an ultrasound probe into a blood vessel in the groin or wrist. They guide the catheter to the heart and ultrasound probe uses sound waves to view the heart’s artery walls. IVUS is a type of cardiac catheterization, a group of procedures that use catheters to diagnose or treat heart conditions.

IVUS may be used as a tool to diagnose certain heart conditions, or it may be used during certain procedures, such as angioplasty or atherectomy, to help your doctor clearly visualize your heart and blood vessels. Your provider may use an intravascular ultrasound to:

• Accurately place a small, mesh tube (stent) to open an artery during angioplasty and stenting
• Evaluate whether an existing heart stent has become blocked
• View plaque buildup in the arteries

Your doctor may order an intravascular ultrasound if he or she suspects you have a condition such as:

• Aortic dissection, a tear in the large blood vessel carrying blood away from the heart (aorta)
• Atherosclerosis, plaque buildup that leads to thickened or hardened arteries
• Blood clots, gel-like clumps that form when blood sticks together
• Peripheral artery disease, narrowing or blocking of the arteries outside the heart, usually affecting the lower limbs

Most people don’t have to do anything special to prepare for an intravascular ultrasound. But if your interventional cardiologist is using IVUS during another procedure, you may need to follow some instructions to prepare. You may need to stop eating or drinking by midnight on the day of the procedure. Your care team will likely tell you to wear loose, comfortable clothing and avoid wearing jewelry.

Tell the care team about all the medications you take, including over-the-counter medicines and supplements. Some people may need to stop taking certain medications for a brief period before the procedure.

An IVUS procedure usually lasts an hour or more, depending on if it’s done during another procedure. You receive anesthesia to keep you calm and comfortable. An interventional cardiologist, interventional echocardiographic, and anesthesia specialist work together to perform the test.

During an intravascular ultrasound, an interventional cardiologist:

1. Makes a small incision in your groin and places a hollow, plastic tube (sheath) into a blood vessel
2. Inserts a catheter through the sheath
3. Moves the catheter through the blood vessel to your heart with the guidance of X-ray or ultrasound imaging
4. Threads a wire with an ultrasound probe through the catheter
5. Sends sound waves out from the probe to create ultrasound images
6. Removes the catheter and applies pressure and a bandage to stop any bleeding at the catheter insertion site

You may return home the same day as an intravascular ultrasound, or you may need to stay in the hospital overnight. If your provider used IVUS during an angioplasty and stenting procedure, you’ll receive specific instructions for recovery at home. Most people should rest and avoid strenuous activity for at least 24 hours.

Intravascular ultrasounds are safe tests that don’t use radiation. They don’t have any known harmful side effects and often show clearer pictures than X-rays.

IVUS allows your cardiologist to view your aorta and coronary arteries (blood vessels supplying blood to the heart) in great detail. The test shows your artery walls, including any buildup of fat deposits (plaque) in closer detail than coronary angiography.

IVUS is a low-risk procedure. Complications are very rare but may include:

• Arrhythmias (irregular heart rhythms)
• Blood clots
• Heart attack
• Stroke

Penn interventional cardiologists are among the nation’s leaders in catheter-based procedures. When you choose our team, you benefit from:

• State-of-the-art technology: We offer intravascular ultrasounds in our state-of-the-art imaging and cardiac catheterization laboratory (cath lab). Our interventional imaging specialists are highly skilled in a range of methods that allow us to diagnose and treat heart problems with exceptional visualization and precision.
• Extensive range of techniques: We use the full range of interventional techniques to evaluate the heart, including intravascular ultrasounds. These tools help us make accurate diagnoses and perform complex procedures.
• Treatment for complex cases: We are a major regional referral center, taking on the most complex and severe cases. If you have high risks associated with surgery or have been turned down for open-heart surgery, our interventional cardiologists offer advanced, minimally invasive treatments.