Intravascular Ultrasound
Applied
Type
ModificationConfidence
95%
Created
Mar 19, 2026
Evidence
4 sources
Rationale
The section was updated to include the landmark 2024 PAD guidelines and the 2022 Aortic guidelines, which provide higher-level evidence (Class 2a) for IVUS than previously cited. Abbreviations (IVUS, EVAR, PAD, TEVAR) were expanded on first use as per instructions. The structure was maintained while integrating the new evidence into the existing bulleted format.
Evidence
Verified source
Content Changes
removedadded
* Provides lumen size, wall characteristics, and stent apposition assessment. * Widely used in endovascular aneurysm repair (EVAR) and iliac vein stenting. * **Venous applications:** In iliofemoral venous obstruction, venography often underestimates lesion severity. IVUSIntravascular ultrasound (IVUS) improves detection of non-thrombotic iliac vein lesions and optimizes stent sizing and landing zone selection.selection [@raju2006] [@ali2016]. * **Arterial applications:** In aorto-iliac and femoropopliteal interventions, IVUS confirms vessel sizing, stent apposition, and detects complications such as dissection or underexpansion.underexpansion [@svs2024-d]. In aortic interventions, IVUS is utilized to identify landing zones, confirm branch vessel patency, and assess for endoleaks [@aha2022-c]. * SVS**Guideline guidelines:Recommendations:** The 2024 ACC/AHA/SVS guidelines recommend IVUS as a reasonable adjunct (Class 2a) during peripheral artery disease (PAD) interventions to improve procedural success and clinical outcomes [@svs2024-d]. The 2022 ACC/AHA aortic guidelines support IVUS for optimizing thoracic endovascular aortic repair (TEVAR) and EVAR, particularly in complex endovascularanatomy repair.[@aha2022-c]. [@raju2006]Recent [@ali2016]evidence [@svs2018]suggests that clinical adoption of IVUS may be outpacing current European Society for Vascular Surgery (ESVS) guideline recommendations [@esvs2023].