Johnson Paul M, Patel Jigar, Yeung Michael, Kaul Prashant
Department of Medicine, Division of Cardiology, University of North Carolina, 6037 Burnett-Womack Building, 160 Dental Circle, CB 7075, Chapel Hill, NC, 27599-7075, USA.
Curr Treat Options Cardiovasc Med. 2014 May;16(5):304. doi: 10.1007/s11936-014-0304-7.
The use of intracoronary imaging modalities has seen a significant increase over the past decade, as both imaging quality and delivery systems have improved. Generally accepted best practice indications for using intracoronary imaging include assessment of lesion characteristics prior to stent placement, optimization of stent placement with respect to appropriate sizing, adequate apposition, and expansion and exclusion of edge dissection. Intracoronary imaging plays a particular role in the setting of contemporary left main and bifurcation stenting. Stent interrogation using intracoronary imaging to exclude mechanical causes in the management of in-stent thrombosis has also become conventional. Current clinical guideline recommendations, however, have lagged behind contemporary practice patterns and the use of intravascular ultrasound only carries a class IIa recommendation in the appropriate clinical setting. We discuss the currently available intracoronary imaging modalities and their applications, including intravascular ultrasound (IVUS) and optical coherence tomography (OCT), and review the data supporting their use.
在过去十年中，随着成像质量和输送系统的改善，冠状动脉内成像方式的使用显著增加。使用冠状动脉内成像的普遍公认的最佳实践指征包括在支架置入前评估病变特征、在合适尺寸、充分贴壁、扩张以及排除边缘夹层方面优化支架置入。冠状动脉内成像在当代左主干和分叉支架置入中发挥着特殊作用。在支架内血栓形成的管理中，使用冠状动脉内成像进行支架检查以排除机械原因也已成为常规操作。然而，当前的临床指南建议落后于当代实践模式，并且在适当的临床环境中，血管内超声的使用仅具有IIa类推荐。我们讨论目前可用的冠状动脉内成像方式及其应用，包括血管内超声（IVUS）和光学相干断层扫描（OCT），并回顾支持其使用的数据。
