Routine intravascular ultrasound guidance of percutaneous coronary intervention: A critical reappraisal

James L. Orford, Amir Lerman, David R. Holmes

Research output: Contribution to journalReview articlepeer-review

30 Scopus citations


Intravascular ultrasound (IVUS) has played an integral role in the evolution of interventional cardiology. However, routine IVUS guidance of coronary stent implantation is not supported by a critical reappraisal of the available evidence. Although there is a trend toward a benefit with respect to target lumen revascularization favoring IVUS-guided coronary stent implantation, it is likely that this effect is driven by improved outcomes in small vessels, long coronary stenoses, and possibly saphenous vein graft interventions. No consistent trend in the incidence of death or myocardial infarction is apparent. Furthermore, the safety, efficacy, and effectiveness of IVUS should be taken into account when considering the goals, risks, benefits, and alternatives to such a treatment strategy.

Original languageEnglish (US)
Pages (from-to)1335-1342
Number of pages8
JournalJournal of the American College of Cardiology
Issue number8
StatePublished - Apr 21 2004


  • DES
  • Drug-eluting stent(s)
  • FFR
  • Fractional flow reserve
  • IVUS
  • Intravascular ultrasound
  • MI
  • MLD
  • Minimum lumen diameter
  • Myocardial infarction
  • PCI
  • Percutaneous coronary intervention
  • TLR
  • TVR
  • Target lumen revascularization
  • Target vessel revascularization

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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