Intravascular US: Applications in Interventional Radiology

Interventional radiology applications of intravascular US (IVUS) continue to expand, complementing intraprocedural angiography and providing a unique vantage from which to guide endovascular interventions. Vascular pathologic conditions become sonographi-cally visualized rather than inferred from the planar appearance of the opacified vascular lumen. Perivascular targets become so-nographically visualized rather than approximated on the basis of fluoroscopic landmarks. The authors introduce broad categories of IVUS catheters, namely radial and side-firing varieties, as well as prevailing options for each and their technical specifications. Common applications within interventional radiology are covered in a systems approach, including deep venous thrombosis, May-Thurner syndrome, nutcracker syndrome, transjugular intrahepatic portosystemic shunts, aortic interventions, peripheral arterial dis-ease, and endovascular or perivascular biopsy. Discussions are ac-companied by technical pearls from the authors, and summarized evidence where IVUS has been shown to reduce procedural time, intravascular contrast agent dose, radiation exposure, and morbid-ity in each space is presented. Finally, emerging applications and future directions are discussed. (c) RSNA, 2022 center dot radiographics.rsna.org