Author: Dr. R. de Graaf
Institution: Clinic of Friedrichshafen
Summary
This presentation discusses the differing applications of Intravascular Ultrasound (IVUS) in treating acute venous thrombosis and chronic venous obstruction. By analyzing IVUS-guided surgical strategies for both acute and chronic cases, the study emphasizes IVUS’s critical role in improving long-term patency rates, guiding thrombus removal, and optimizing stent placement. The findings demonstrate that IVUS effectively aids in lesion identification and stent configuration, optimizing treatment outcomes.
Introduction
Success in venous interventions, along with long-term patency, often depends on the accurate identification and evaluation of lesions. IVUS plays a vital role in treating both acute venous thrombosis and chronic post-thrombotic obstruction, providing real-time lesion information to guide treatment strategies. This presentation aims to explore the differences in IVUS applications across various venous lesion types, helping interventionalists increase procedural success.
Applications in Acute Venous Thrombosis
•Success Factors: Successful treatment of acute thrombosis primarily relies on complete thrombus removal and addressing the underlying cause. IVUS helps guide comprehensive thrombus removal, preventing residual lesions and increasing procedural success.
•Cause Identification: IVUS assists in identifying the root causes of thrombosis, ensuring that treatments target both symptoms and the lesion’s origin.
Applications in Chronic Post-Thrombotic Obstruction
•Determinants of Long-Term Patency: Successful treatment of chronic venous obstruction depends on lesion evaluation and precise stent placement. IVUS aids in defining lesion extent and optimizing stent positioning, ensuring long-term patency.
•Stent Configuration Assessment: IVUS provides real-time monitoring of stent placement, ensuring proper location, inflow, and stent morphology, reducing the risk of restenosis.
Case Studies
•Case 1: A 56-year-old male with acute venous thrombosis underwent IVUS-guided thrombus removal, resulting in complete clearance and prevention of long-term complications.
•Case 2: A 45-year-old female with chronic post-thrombotic obstruction received a successful IVUS-guided stent implantation, restoring venous patency without restenosis during follow-up.
Conclusion
IVUS plays a crucial role in venous interventions, particularly in guiding thrombus removal, assessing lesions, and optimizing stent placement. In both acute and chronic cases, IVUS provides precise real-time imaging, enabling clinicians to make the best treatment decisions and significantly improve long-term patency rates.
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