Intravascular Imaging IVUS and OCT Flashcards
What do you administer before the IVUS/OCT catheter is advanced over the guidewire?
Heparin and IC nitroglycerin
Where do you place the IVUS/OCT catheter in reference to the lesion?
Distal in order to pullback
When is artifact the most common in IVUS during nonuniform rotation distortion?
Artifact occurs in tortuous vessels.
What do you measure to and from in IVUS in plaque?
Neointimal layer to adventitia
What does soft plaque look like in IVUS?
-80% of plaque area
-Homogeneous echo density less than adventita
What does fibrous plaque look like in IVUS?
-80% of plaque area
-Thick and homogenous
-Echo density greater or equal to adventita
What does calcified plaque look like in IVUS?
-90% of vessel wall circumference in at least one cross-sectional image
-Hyperechogenic structure
What does mixed plaque look like on IVUS?
-Bright echos with shadowing less than 90% of the vessel wall
-Fibrous plaque is seen with less than 80% of the area
What does sub intimal thickening look like on IVUS?
-Referencing vessel segments
-Echo lucent zone thickness more than 500 microns
What is the one clinical situation in which physiological index is not used for lesions?
Intermediate Left main Stenosis
What is one of the principal barriers to achieving optimal stent area?
Calcium
What is the most effective strategy to avoid postprocedure acute kidney injury?
Limit the total contrast administered
What type of IVUS imaging is there?
-Phased Array
-Rotational
What MHz is in phased array IVUS?
20 MHz
What MHz range is in Rotational IVUS?
40-60 MHz
What is preferred for imaging aorto-ostial lesions and why?
IVUS
Harder to clear contrast from the lesion
What is the minimum stent lumen area for Left Main IVUS and OCT?
> 8.00 mm
What is the minimum stent lumen area for Non-Left Main lumen area IVUS?
> 5.5mm
What is the cutoff for left main significance in OCT?
5.4 mm
What is the minimum stent lumen area for non left main lesions in OCT?
4.5 mm
