Coronary Intravascular Ultrasonography (Coronary Sonogram, Coronary Ultrasound)

Norm of Coronary Intravascular Ultrasonography (Coronary Sonogram, Coronary Ultrasound)

Three-dimensional view of the inside of vasculature. Normal coronary vascular anatomy; absence of coronary artery narrowing or occlusion; absence of coronary artery luminal irregularities.

 

Usage of Coronary Intravascular Ultrasonography (Coronary Sonogram, Coronary Ultrasound)

Provides information regarding tissue characterization, morphology, and the precise measurement of the dimensions of the coronary arteries; identification of plaque and thrombus as well as other luminal irregularities; assessment of the coronary arteries before and after coronary angioplasty; identification of the best location for the placement of arterial stents (a coil wire used to keep arteries open in clients with occluded arteries). Helps check for stent expansion after placement of intracoronary stents. Also used for the location of atherosclerotic plaque formation before removal during cardiac catheterization.

 

Description of Coronary Intravascular Ultrasonography (Coronary Sonogram, Coronary Ultrasound)

An invasive ultrasound performed from a transducer within the lumen of the coronary arteries. The intravascular ultrasound uses a tiny transducer, about 1 mm in diameter, that is fed through a catheter leading to the heart from a femoral vessel. Similar to those seen in ultrasonograms and echocardiograms, ultrasound images of the inside of the arteries appear on a monitor, offering a clear picture of the inside of the vessel. The images allow visualization of tears, precise determination of the size and shape of plaque buildup or a blood clot, or evaluation of the effectiveness of an angioplasty. This procedure is extremely useful in the evaluation of left main coronary artery narrowing. It is performed with coronary catheterization and angiography. A baseline impression, depicted through tissue differentiation, can provide insight into the progression and degree of coronary artery disease. When used with other procedures, the ultrasonogram requires about 5 minutes of time to complete.

 

Professional Considerations of Coronary Intravascular Ultrasonography (Coronary Sonogram, Coronary Ultrasound)

Consent form IS required. Consent for this procedure may be included with the consent for cardiac catheterization and angiography.

Risks Prolonged bleeding, hemorrhage, cerebrovascular accident, hypotension, death. Contraindications No different from those for cardiac catheterization.

 

Preparation

1. See Cardiac catheterization. No additional preparation is necessary for this procedure.

 

Procedure

1. An 8-French, transducer-tipped catheter is placed over a guidewire into the coronary artery. The sound beam is swept through a series of radial positions within the perimeter of a well-defined cross-sectional plane. The echo information is then converted into a “real-time” cross-sectional image of the vessel.
2. This procedure increases the length of a cardiac catheterization procedure by approximately 15 minutes and requires a larger dose of heparin.
3. Just before beginning the procedure, take a “time out” to verify the correct client, procedure, and site.

 

Postprocedure Care

1. Because additional heparinization is required when this procedure is added to a cardiac catheterization, the immediate postprocedure bed rest requirements may be prolonged.
2. See Cardiac catheterization.

 

Client and Family Teaching

1. See Cardiac catheterization.

 

Factors That Affect Results

1. None found.

 

Other Data

1. Complications of this procedure include the potential for lifting plaque or thrombus from the vessel lumen because the tip of the transducer actually enters the coronary artery, as well as potential complications listed under Cardiac catheterization.