ISNVD Abstract Book

Doctors who are using IVUS routinely have found this diagnostic tool to be incredibly helpful as an
adjunctive to catheter venography. No matter how one manipulates contrast dilution or injection
speed, venography does not come close to the sensitivity of IVUS in detection of endoluminal
anomalies (septae, thrombus, chronic organized/recanalized thrombus, valvular anomalies, valve
leaflet morphology, phasic venous anatomical variability, etc.). IVUS can be performed extremely
safely with minimal change in guide catheters being utilized, fluoroscopy time and contrast volume.
While many patients demonstrate venographic anomalies, IVUS yields many more anomalies, since
CCSVI appears to be principally an endoluminal disease. Thus, a combination of venography and
IVUS provides a comprehensive assessment of venous anatomy, endoluminal structures and flow,
which would be inadequate with either technique by itself.
At the moment the use of IVUS is recommended for the diagnosing CCSVI. However, actual
diagnostic value of this test should be evaluated by ongoing research. Of special importance will be
the problem – whether the management of lesions that can be diagnosed only with IVUS and not with
venography alone, will give an additional clinical benefit to the patients.
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