ABSTRACT
Balloon angioplasty was first performed in the late 1970s. Devices were developed in an attempt to improve on the acute and long-term results of balloon angioplasty. Today, most interventional procedures involve routine stent implantation. Provisional stentingin which aggressive balloon angioplasty is attempted first and stent implantation reserved for inadequate results-has been adopted by a few interventionalists, either for cost reasons or because of the concern for high bare-metal stent restenosis rates. This concern is likely to diminish in the era of drug-eluting stents. The other devices continue to be used by only a small minority of interventionalists. Therefore, the bulk of this chapter will focus on IVUS in stent implantation and, in particular, the recognition of complications that are common to all interventional procedures. The figures in this chapter were collected during a 12-year period in the evolution of interventional cardiology; they are meant to illustrate, not advocate, the approach to lesion morphology and the therapeutic results. All of the IVUS illustrations are at the same scale (magnification). Multiple examples are often included to show the consistency of the IVUS findings.
