Intravascular ultrasound useful in arterial and venous lower extremity interventions: JACC

USA: A new international consensus document has stated that the use of intravascular ultrasound (IVUS) imaging can guide operators in a variety of clinical scenarios involving lower-extremity arterial and venous interventions. The article appears in JACC: Cardiovascular Interventions. 

During lower extremity arterial and venous revascularization, there has been a growing use of IVUS. Observational data have shown that IVUS use can improve periprocedural and long-term outcomes but there is a dearth of largescale prospective data. Hence, there arises a need for the appropriate use of IVUS during the peripheral intervention. 

Acknowledging the gap in high-quality data, Eric A. Secemsky, Harvard Medical School, Boston, Massachusetts, USA, and colleagues aimed to provide guidance on the appropriate use of IVUS in various phases of peripheral arterial and venous interventions in a consensus document.

For this purpose, a 12-member writing committee was convened to derive consensus regarding the appropriate clinical scenarios for peripheral IVUS use. A 72-question survey representing 12 lower extremity arterial interventional scenarios was iteratively created by the group. A 40-question survey representing 8 iliofemoral venous interventional scenarios was separately constructed. 

Clinical scenarios were categorized by interventional phases: preintervention, intraprocedural, and postintervention optimization. The survey instrument was completed by thirty international vascular experts (15 for each survey). Using the median value and disseminated to the voting panel to reevaluate for any disagreement, results were categorized by appropriateness.