Contrast-enhanced intravascular ultrasound: Validation of a new technique for delineation of the vessel wall boundary

Hausmann, Dirk; Sudhir, Krishnankutty; Mullen, William L.; Fitzgerald, Peter J.; Ports, Thomas A.; Daniel, Werner G.; Yock, Paul G.

doi:10.1016/0735-1097(94)90647-5

Cited by 18 publications

(8 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Hausmann et al reported that in performing IVUS on a dog coronary artery, the intracoronary administration of an echogenic contrast agent improved the the border's detectability in the coronary artery lumen. 21 Takaiwa et al also reported that when assessing coronary artery lesions before and after intervention, the administration of an echogenic contrast agent with IVUS was useful. 22 In the present study, the border between the in-stent neointima and the vessel lumen in the IVUS images was delineated vividly for all 24 subjects after the intracoronary infusion of an echogenic contrast agent.…”

Section: Discussionmentioning

confidence: 99%

Improved Reproducibility of Intravascular Ultrasound Assessment of Coronary In-Stent Neointima With the Use of an Echogenic Contrast Agent

2001

View full text Add to dashboard Cite

he intracoronary placement of metallic stents has been used to improve the results of balloon angioplasty for coronary lesions and to relieve acute or threatened occlusions from large dissections. [1][2][3] However, as a long-term therapeutic treatment of coronary artery disease, stenting remains limited because of the problem of recurring stenotic lesions (restenosis). The process of coronary arterial narrowing after stent implantation is mediated by neointimal proliferation in the stented coronary artery rather than by stent recoil or thrombus formation. Neointimal thickening may play a main role in the development of restenosis after stent implantation. [4][5][6][7] The in-stent restenosis rate has been reported to be 10-30%. [8][9][10][11][12] Recent technological progress has allowed the use of 2-dimensional intravascular ultrasound (IVUS) as an investigative technique in the cardiac catheterization laboratory. The IVUS technique allows tomographic imaging of the cross-sectional area of a coronary artery and characterization of the morphology of the intima, media, and adventitia of the coronary artery wall. 13 Therefore, IVUS is a useful method for evaluating neointimal thickening in stented coronary arteries but, because the acoustic impedance of in-stent neointima is similar to that of blood cells, occasionally there are some difficulties in differentiating lumen from in-stent neointima. This may be due partly because blood gives a strong backscatter signal, especially in areas with low blood flow. 14 In the present study, we used an echogenic contrast agent during IVUS (contrast IVUS) to evaluate a new technique that has the potential to improve the border detection of in-stent neointima. We also studied the reproducibility of IVUS measurements for an in-stent neointima area both with and without the use of an echogenic contrast agent and compared the results. Methods SubjectsThe study comprised 24 subjects (22 men and 2 women, 63±10 years of age) who had undergone an intracoronary stent implant with a Palmaz -Schatz stent at our hospital between August 1994 and May 1995, and whose stents were monitored by IVUS during the chronic phase [between the third and tenth month (mean 6.5±1.5 months)]. There were 20 cases of old myocardial infarction and 4 cases of angina pectoris. Stent placement had been conducted against restenosis after intervention in 16 cases, and against de novo lesions in 8 cases. Informed consent was obtained from all subjects prior to the study. Intracoronary StentingThe Palmaz -Schatz stent implanted in all patients was 15 mm in length. There were 3 types of stents of different diameters: (i) 3 mm stents were implanted in 14 patients; (ii) 3.5 mm stents were implanted in 9 patients; and (iii) a 4 mm stent was implanted in 1 patient. The patients' coronary arteries were the left anterior descending (LAD) in 13 cases, the left circumflex (LCX) in 1 case, and the right The present study evaluated a new technique that has the potential to improve the border detection of in-stent neointima ...

show abstract

Section: Discussionmentioning

confidence: 99%

Improved Reproducibility of Intravascular Ultrasound Assessment of Coronary In-Stent Neointima With the Use of an Echogenic Contrast Agent

2001

View full text Add to dashboard Cite

show abstract

“…Some experiments have shown the feasibility and safety of contrastenhanced ICUS [9,10], but to our knowledge this is the first report of the suitable contrast agents for ICUS in humans.…”

Section: Discussionmentioning

confidence: 96%

“…Delineation percentage was determined as the percentage of the patients with arterial circumference visualized clearly after injection of each contrast agent within all the patients. To evaluate the homogeneity of luminal contrast, the optimal end-systolic frame was selected and qualitative grading was performed according to Hausmann et al [10]: 0 ϭ no bubbles; 1 ϭ individual microbubbles discernible; 2 ϭ a mixture of individual microbubbles and homogeneous opacification; 3 ϭ completely homogeneous throughout. We evaluated coronary homogeneity and false lumen homogeneity using this scoring system.…”

Section: Analysis Of Imagesmentioning

confidence: 99%

“…However, it is sometimes difficult to visualize dissections, tears, and flaps even by ICUS [7,8]. Recently, animal studies have demonstrated that contrast medium can improve image quality and the accuracy of measurement of the coronary arteries [9,10]. Intracoronary administration of echogenic contrast agents has been widely used for evaluation of myocardial perfusion in humans [11][12][13][14][15], and these studies have proven the safety of such agents.…”

Section: Introductionmentioning

confidence: 98%

See 1 more Smart Citation

Evaluation of contrast agents for delineation of vessel wall boundary by intracoronary ultrasound after coronary angioplasty in human

Nishino

Tanouchi

Kawabata

et al. 1999

Cathet. Cardiovasc. Intervent.

View full text Add to dashboard Cite

“…1 An echogenic contrast agent like sonicated ioxaglate is safe and effective for myocardial contrast echocardiography. 2 Although contrast agents may detect a dissection plane or an ulcerated plaque that is connected to the lumen, 1 subtle morphologic changes of the luminal surface may be missed due to backscatter from blood cells. To overcome these technical difficulties, we injected 5% glucose solution into the coronary artery during IVUS imaging to provide a negative contrast agent that avoids backscatter from red blood cells.…”

mentioning

confidence: 99%

Clinical utility of negative contrast intravascular ultrasound to evaluate plaque morphology before and after coronary interventions

Honye

Saito

Takayama

et al. 1999

The American Journal of Cardiology

View full text Add to dashboard Cite

show abstract

Contrast-enhanced intravascular ultrasound: Validation of a new technique for delineation of the vessel wall boundary

Abstract: This preliminary study shows that delineation of the vessel wall boundary using echogenic contrast agents during intravascular ultrasound is safe and feasible. Because of higher contrast intensity and homogeneity, SHU 454 and SHU 508 are superior to other agents.

Cited by 18 publications

References 24 publications

Improved Reproducibility of Intravascular Ultrasound Assessment of Coronary In-Stent Neointima With the Use of an Echogenic Contrast Agent

Improved Reproducibility of Intravascular Ultrasound Assessment of Coronary In-Stent Neointima With the Use of an Echogenic Contrast Agent

Evaluation of contrast agents for delineation of vessel wall boundary by intracoronary ultrasound after coronary angioplasty in human

Clinical utility of negative contrast intravascular ultrasound to evaluate plaque morphology before and after coronary interventions

Contact Info

Product

Resources

About