ABSTRACT
Over the last two decades, intravascular ultrasound (IVUS) imaging has played a pivotal role in optimizing the technique of coronary stenting as it is currently practiced. In the early 1990s, two major limitations to coronary stenting seemed to prevent interventional cardiologists from adopting it on a large scale. The first was dramatic acute and subacute stent thrombosis and the need for intense anticoagulation, and the second was the slower paced process of stent restenosis. IVUS imaging was crucial in teaching the interventional cardiology community about the limitations of stenting techniques and subsequently provided the basis for the technical modifications that resulted in markedly improved results. That, coupled with better understanding of the role of antiplatelet therapy, eventually led to the explosive growth of coronary stenting as it is performed today. With the introduction of drug-eluting stents (DES), IVUS imaging was again instrumental in understanding the mechanisms of markedly improved restenosis rates and possible mechanisms of the resurgent stent thrombosis problem.
