Evidence for Intravascular Ultrasound (IVUS) in PAD

Evidence for IVUS in PAD

This episode uncovers the compelling evidence behind Intravascular Ultrasound (IVUS), a technology that is revolutionizing the treatment of Peripheral Artery Disease (PAD) by fixing the fundamental flaw of traditional angiography: its "2D shadow" limitation.

• The Problem with Angiography: Standard X-ray imaging forces doctors to guess the size of 3D arteries from 2D pictures, leading to poor device sizing and missed complications like dissections.

• The IVUS Advantage: IVUS provides a 360-degree blueprint from inside the artery, allowing for precise sizing and detection of calcified plaque that angiography misses.

• Real-World Impact: A massive analysis of 500,000 patients showed that using IVUS is associated with a stunning 27% reduction in Major Adverse Limb Events (MALE) and a significant drop in major amputations.

• The "Wow" Stat: In a randomized trial, IVUS findings forced doctors to change their treatment plan in nearly 79% of cases, proving that standard angiography leads to suboptimal decisions four out of five times.

• Barriers to Use: Despite this data, IVUS is used in only ~12% of cases due to poor hospital reimbursement policies that penalize better care, highlighting a critical need for systemic reform.

Tune in to learn why IVUS isn't a luxury—it's a necessity for better outcomes and limb preservation.

Based on comments from experts, content on Wysdom, and the article cited below.

Secemsky EA, Aronow HD, Kwolek CJ, et al. Intravascular ultrasound use in peripheral arterial and deep venous interventions: multidisciplinary expert opinion from SCAI/AVF/AVLS/SIR/SVM/SVS. J Soc Cardiovasc Angiogr Interv. 2024;3(1):101205. doi:10.1016/j.jscai.2023.101205