WASHINGTON – Proceedings from an expert consensus roundtable that brought together leading experts to discuss the benefits of intravascular ultrasound (IVUS) in lower extremity revascularization procedures were released today in the Journal of the Society for Cardiovascular Angiography and Interventions (JSCAI), Journal of Vascular and Interventional Radiology (JVIR), and Journal of Vascular Surgery-Vascular Insights.
The discussions focused on the current challenges in diagnosing and treating lower extremity arterial occlusive disease, knowledge and data gaps, and the potential role of IVUS in addressing these challenges. Experts shared their insights and experiences from interventional cardiology, interventional radiology and vascular surgery. Six professional societies co-sponsored the expert opinion consensus meeting: SCAI, Society for Vascular Medicine (SVM), Society for Vascular Surgery (SVS), American Venous Forum (AVF), American Vein and Lymphatic Society (AVLS), and Society of Interventional Radiology (SIR).
"Improvements in outcomes following peripheral vascular intervention have lagged compared to other endovascular treatments, such as percutaneous coronary intervention. Both clinical experience and evidence support the greater use of peripheral IVUS to reduce adverse events and extend the patency of our lower extremity revascularization procedures. By gathering experts from different specialties, we aimed to foster collaboration and exchange ideas to improve patient care for peripheral IVUS," said Eric A. Secemsky, MD, MSc, FSCAI, lead author of the proceedings document and Director of Vascular Intervention, Beth Israel Deaconess Medical Center. "The roundtable provided a unique opportunity to identify knowledge gaps and discuss how IVUS can enhance our understanding and treatment of peripheral arterial and deep venous pathology."
Lower extremity revascularization is a critical procedure used to restore blood flow to the legs and feet in patients suffering from peripheral arterial disease (PAD) and improve venous drainage in people with venous obstruction. It is estimated that millions of people worldwide are affected by these conditions, which can lead to severe pain, non-healing wounds, and even limb loss if left untreated. Although angiography is the dominant imaging modality during revascularization procedures, it has inherent limitations. IVUS is a minimally invasive imaging technique that allows physicians to visualize the inside of blood vessels in real-time. It provides detailed information about the vessel wall, plaque composition, and blood flow characteristics, enabling more accurate diagnosis and treatment planning.
During the roundtable, participants highlighted the potential of IVUS in guiding revascularization procedures, such as angioplasty and stenting, to optimize outcomes for patients. They also emphasized the need for further research and evidence to support the integration of IVUS into routine clinical practice.
“IVUS has already shown its utility in patients undergoing intervention for aortic dissection and acute and chronic venous disease. It holds promise when utilized in the treatment of patients with PAD. We hope this multidisciplinary round table provides insights and spurs other investigators from all of our respective fields to work together to attempt to scientifically study and better define the utility of IVUS to improve the outcomes of lower extremity arterial interventions,” said Joseph Mills, president of the SVS. The roundtable concluded with a commitment to ongoing interdisciplinary collaboration and knowledge sharing among physicians. Participants agreed that treatment standards, formal training programs and global quality metrics remain needed to improve patient care.
The insights and recommendations generated from this discussion are now available in the Journal of the Society for Cardiovascular Angiography and Interventions (JSCAI).
The considerations and consensus views shared in “Intravascular Ultrasound Use in Peripheral Arterial and Deep Venous Interventions: Multidisciplinary Expert Opinion From SCAI/AVF/AVLS/SIR/SVM/SVS” represent the opinion of the consensus committee members from SCAI, AVF, AVLS, SIR, SVM, and SVS solely.
Read the publication: Secemsky, EA, Aronow HD, Kwolek, CJ, et al. Intravascular ultrasound use in peripheral arterial and deep venous interventions: multidisciplinary expert opinion from SCAI/AVF/AVLS/SIR/SVM/SVS. JVS-Vascular Insights. Published online January 9, 2024. doi: 10.1016/j.jvsvi.2023.100033.
###
About the Society for Vascular Surgery:
The Society for Vascular Surgery® (SVS) seeks to advance excellence and innovation in vascular health through education, advocacy, research, and public awareness. The organization was founded in 1946 and currently has a membership of more than 6,300. SVS membership is recognized in the vascular community as a mark of professional achievement.