Abstract
Intravascular ultrasound (IVUS) is used as a diagnostic adjunct to angiography and has become a valuable diagnostic and interventional tool with a well-documented safety profile. The American College of Cardiology and the European Society of Cardiology have published guidelines regarding the use of IVUS in the setting of percutaneous coronary intervention. IVUS has gained popularity in the interventional radiology (IR) community in recent years; however, there are no consensus guidelines for utilization. Furthermore, IVUS remains an infrequently used modality in pediatric IR, likely because of unfamiliarity with the equipment and techniques, as well as concerns over the compatibility of these instruments with pediatric anatomy. IVUS can be safely used as a helpful and sometimes necessary tool for pediatric interventions in appropriately selected patients. The utility of IVUS for reducing both fluoroscopy time and contrast agent volume makes it particularly valuable in pediatric practice. This article presents an overview of both the rotational and phased-array IVUS types and an in-depth discussion on the most common applications of these techniques in the pediatric setting across multiple procedure categories.
Similar content being viewed by others
References
Yock PG, Linker DT, Thapilyal HV et al (1988) Real-time two-dimensional catheter ultrasound: a new technique for high-resolution intravascular imaging. J Am Coll Cardio 11:130A
Belkin N, Jackson BM, Foley PJ et al (2020) The use of intravascular ultrasound in the treatment of type B aortic dissection with thoracic endovascular aneurysm repair is associated with improved long-term survival. J Vasc Surg 72:490–497
Tsujita K, Maehara A, Mintz GS et al (2008) Comparison of angiographic and intravascular ultrasonic detection of myocardial bridging of the left anterior descending coronary artery. Am J Cardiol 102:1608–1613
Nissen SE, Yock P (2001) Intravascular ultrasound: novel pathophysiological insights and current clinical applications. Circulation 103:604–616
Shlofmitz E, Kerndt CC, Parekh A, Khalid N (2020) Intravascular ultrasound. StatPearls, Treasure Island. http://www.ncbi.nlm.nih.gov/books/NBK537019/. Accessed 21 Sep 2021
Levine GN, Bates ER, Blankenship JC et al (2011) 2011 ACCF/AHA/SCAI guideline for percutaneous coronary intervention: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines and the Society for Cardiovascular Angiography and Interventions. JACC 58:e44-122
Neumann J, Sousa-Uva M, Ahlsson A et al (2019) 2018 ESC/EACTS guidelines on myocardial revascularization. Eur Heart J 40:87–165
Sheikh AB, Anantha-Narayanan M, Smolderen KG et al (2020) Utility of intravascular ultrasound in peripheral vascular interventions: systematic review and meta-analysis. Vasc Endovasc Surg 54:413–422
Elgendy IY, Mahmoud AN, Elgendy AY, Bavry AA (2016) Outcomes with intravascular ultrasound-guided stent implantation: a meta-analysis of randomized trials in the era of drug-eluting stents. Circ Cardiovasc Interv 9:e003700
Ahn J-M, Kang S-J, Yoon S-H et al (2014) Meta-analysis of outcomes after intravascular ultrasound–guided versus angiography-guided drug-eluting stent implantation in 26,503 patients enrolled in three randomized trials and 14 observational studies. Am J Cardiol 113:1338–1347
Loffroy R, Falvo N, Galland C et al (2020) Intravascular ultrasound in the endovascular treatment of patients with peripheral arterial disease: current role and future perspectives. Front Cardiovasc Med 7:551861
Marteslo JP, Makary MS, Khabiri H et al (2020) Intravascular ultrasound for the peripheral vasculature — current applications and new horizons. Ultrasound Med Biol 46:216–224
Petersen B, Uchida BT, Timmermans H et al (2001) Intravascular US-guided direct intrahepatic portacaval shunt with a PTFE-covered stent-graft: feasibility study in swine and initial clinical results. J Vasc Interv Radiol 12:475–486
Pillai A, Andring B, Iyamu I (2016) Conventional vs. intravascular ultrasound (IVUS) guided transjugular intrahepatic portosystemic shunt (TIPS) creation: a comparison of success, efficiency, complications, and radiation dose. J Vasc Interv Radiol 27:S194
Monroe EJ, Shin DS, Shivaram GM, Koo KSH (2017) Pediatric transjugular intrahepatic portosystemic shunts. Dig Dis Interv 1:277–285
Koo KSH, Lamar DL, Shaw DWW et al (2018) Catheter-directed thrombolysis for portal vein thrombosis in children: a case series. J Vasc Interv Radiol 29:1578–1583
Hodgkiss-Harlow K, Back MR et al (2012) Technical factors affecting the accuracy of bedside IVC filter placement using intravascular ultrasound. Vasc Endovasc Surg 46:293–299
McDevitt JL, Srinivasa RN, Hage AN et al (2019) Total endovenous recanalization and stent reconstruction for naïve non-inferior vena cava filter-associated chronic iliocaval occlusive disease: placement of 352 venous stents in 69 debilitated patients. Vasc Med 24:349–358
Chick JFB, Jo A, Meadows JM et al (2017) Endovascular iliocaval stent reconstruction for inferior vena cava filter–associated iliocaval thrombosis: approach, technical success, safety, and two-year outcomes in 120 patients. J Vasc Interv Radiol 28:933–939
McDevitt JL, Srinivasa RN, Gemmete JJ et al (2019) Approach, technical success, complications, and stent patency of sharp recanalization for the treatment of chronic venous occlusive disease: experience in 123 patients. Cardiovasc Intervent Radiol 42:205–212
Chick JFB, Roush BB, Khaja MS et al (2017) Transbiliary intravascular ultrasound-guided diagnostic biopsy of an inaccessible pancreatic head mass. Radiol Case Rep 12:323–326
Yan F, Rajah G, Ding Y et al (2019) Safety and efficacy of intravascular ultrasound as an adjunct to stenting for cerebral venous sinus stenosis-induced idiopathic intracranial hypertension: a pilot study. J Neurosurg 132:749–754
Clark DJ, Lessio S, O’Donoghue M et al (2004) Safety and utility of intravascular ultrasound-guided carotid artery stenting. Catheter Cardiovasc Interv 63:355–362
Enriquez A, Saenz LC, Rosso R et al (2018) Use of intracardiac echocardiography in interventional cardiology: working with the anatomy rather than fighting it. Circulation 137:2278–2294
Raju S, Buck WJ, Crim W, Jayaraj A (2018) Optimal sizing of iliac vein stents. Phlebology 33:451–457
Gill AE, Ciszak T, Braun H, Hawkins CM (2017) Intravascular ultrasound versus digital subtraction angiography: direct comparison of intraluminal diameter measurements in pediatric and adolescent imaging. Pediatr Radiol 47:450–457
Manninen HI, Räsänen H (2000) Intravascular ultrasound in interventional radiology. Eur Radiol 10:1754–1762
Zhao X, Zhao L, Wu L et al (2020) Efficacy of percutaneous transluminal renal angioplasty for pediatric renovascular hypertension: a meta-analysis. Zhonghua Er Ke Za Zhi 58:661–667
McDevitt JL, Srinivasa RN, Hage AN et al (2019) Lower extremity endovenous reconstruction for symptomatic occlusive disease in pediatric patients: techniques, clinical outcomes, and long-term stent patencies. Pediatr Radiol 49:808–818
Montminy ML, Thomasson JD, Tanaka GJ et al (2019) A comparison between intravascular ultrasound and venography in identifying key parameters essential for iliac vein stenting. J Vasc Surg Venous Lymphat Disord 7:801–807
Aslesen A (2019) Assessing venous disease for optimal endovascular stent placement. BackTable podcast. https://www.backtable.com/post/endovascular-stent-placement-venous-disease. Accessed 21 Sep 2021
Sherman TF (1981) On connecting large vessels to small. The meaning of Murray’s law. J Gen Physiol 78:431–453
Hager ES, Yuo T, Tahara R et al (2013) Outcomes of endovascular intervention for May-Thurner syndrome. J Vasc Surg Venous Lymphat Disord 1:270–275
Majdalany BS, Khaja MS, Williams DM (2017) Intravascular ultrasound-guided intervention for May-Thurner syndrome. Semin Interv Radiol 34:201–207
Wu Z, Zheng X, He Y et al (2016) Stent migration after endovascular stenting in patients with nutcracker syndrome. J Vasc Surg Venous Lymphat Disord 4:193–199
Cronan JC, Hawkins CM, Kennedy SS et al (2021) Endovascular management of nutcracker syndrome in an adolescent patient population. Pediatr Radiol 51:1487–1496
Syed MI, Yu B, Akhter T, Shaikh A (2011) Renal vein stenting via the right internal jugular approach with a provocative Valsalva maneuver to reduce the risk of stent migration. Perspect Vasc Surg Endovasc Ther 23:268–271
Petersen BD, Clark TWI (2008) Direct intrahepatic portocaval shunt. Tech Vasc Interv Radiol 11:230–234
Kew J, Davies RP (2004) Intravascular ultrasound guidance for transjugular intrahepatic portosystemic shunt procedure in a swine model. Cardiovasc Intervent Radiol 27:38–41
Kao SD, Morshedi MM, Narsinh KH et al (2016) Intravascular ultrasound in the creation of transhepatic portosystemic shunts reduces needle passes, radiation dose, and procedure time: a retrospective study of a single-institution experience. J Vasc Interv Radiol 27:1148–1153
Bertino F, Hawkins CM, Shivaram G et al (2019) Technical feasibility and clinical effectiveness of transjugular intrahepatic portosystemic shunt creation in pediatric and adolescent patients. J Vasc Interv Radiol 30:178–186
Chamarthy MR, Anderson ME, Pillai AK, Kalva SP (2016) Thrombolysis and transjugular intrahepatic portosystemic shunt creation for acute and subacute portal vein thrombosis. Tech Vasc Interv Radiol 19:42–51
Thakrar PD, Petersen BD, Kaufman JA (2013) Intravascular ultrasound for transvenous interventions. Tech Vasc Interv Radiol 16:161–167
RiChard J, Thornburg B, Desai S et al (2019) Intracardiac echocardiography (ICE)-guided external iliac transvenous needle biopsy of an extravascular retroperitoneal mass. Int J Clin Ski 13:259–263
Swenson C, Martin JG, Jaffe T et al (2021) Intravascular ultrasound guided transvenous biopsy of abdominal and pelvic targets difficult to access by percutaneous needle biopsy: technique and initial clinical experience. J Vasc Interv Radiol 32:1310–1318
Kaufman C, Gaumond J, Kaufman J (2017) Transjugular liver biopsy following orthotopic whole liver transplantation: challenges and solutions. A pictorial essay. J Clin Interv Radiol 1:107–112
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflicts of interest
Jeffrey Forris Beecham Chick is a consultant and speaker for Inari Medical, Guerbet, C. R. Bard, Argon Medical Devices and Boston Scientific. Eric J. Monroe is a scientific adviser and speaker for Biogen.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Weaver, J.J., Shin, D.S., Chick, J.F.B. et al. Intravascular ultrasound for endovascular precision in pediatrics. Pediatr Radiol 52, 559–569 (2022). https://doi.org/10.1007/s00247-021-05220-7
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00247-021-05220-7