IVUS – basic informationIntravascular ultrasound (IVUS) is a moderninvasive method of diagnostic imaging.By using ultrasounds, IVUS allows more precisevessels anatomy imaging. The primary benefit of IVUS isthat it offers a tomographic, 360-degree view of thevessel’s wall from the inside, allowing more completeand accurate assessment than it is possible with theuse of venography examination.Using IVUS in the diagnostics of Chronic CerebrospinalVenous Insufficiency (CCSVI) allows more accurateassessment of venous pathologies (such as narrowings)and more precise selection of balloon catheters used inthe venous angioplasty procedures.In the CCSVI treatment, AMEDS Centrum physicians usehigh-pressure balloons and cutting balloons.
Which of the veins are assessed during IVUS examination?Azygos vein and jugular veins are assessed duringevery IVUS examination. Examination of renal andiliac veins is performed when the lumens of thevessels do allow such possibility – the vesselcannot be too wide or IVUS device will not providea full intravascular view.If IVUS imaging show major pathologies withinrenal and/or iliac veins, it is possible to proceedwith angioplasty of these vessels during the sameprocedure.
Indications for IVUS Is it possible for every patient to have IVUS examination? One has to remember that IVUS examination is an invasive diagnostic technology. Indication for venography examination is necessary to perform IVUS examination. How about the patients without visible venous pathologies in Doppler examination? Is it possible to perform IVUS in those cases? Yes, but only if there are reasons to expect the presence of the pathologies in the azygos vein.
IVUS vs. walking improvements Is it true that using IVUS may bring improvements in walking and balance? If so, why? IVUS may provide physicians with detailed information about the azygos vein of which narrowings may cause mobility problems. IVUS examination enables detection of septas, diaphagrams, pathological valves which cannot be properly visualized by venography. These pathologies are often present in the azygos vein, responsible for the drainage of the spinal cord. The lesions in the spinal cord may cause walking problems.
Does IVUS help in CCSVI treatment? There are rumors that IVUS helps in CCSVI treatment. Why is it so? IVUS is a diagnostic examination. Thanks to its use it is possible to optimize venous angioplasty results. Why? Because IVUS imaging provides physicians with more accurate information regarding localization and dimension of the venous pathologies, what allows more precise balloon selection. IVUS is a more sensitive tool in finding the lesions which might not be seen by venography. When balloon angioplasty is performed and the effects are ambiguous, IVUS can rule out the doubts.
IVUS and stents I had a stent which was inserted during my CCSVI procedure. Can I undergo IVUS exam? Yes, if the indications to perform venography are present. In such case, it is even strongly indicated to have the IVUS examination done, as IVUS assessment may be very valuable in the further diagnostic and treatment process. IVUS imaging gives detailed information about the vessel section, what improves the accuracy of general assessment, also regarding potential thrombosis and other issues that may be connected to the previous stent insertion. How about the patients with thrombosis in the stent? If the thrombosis does not occlude the lumen of the vessel totally, it is possible to perform IVUS examination.