Dr. Isaacson points to an intravascular ultrasound image of a patient's coronary artery filled with plaque.
A unique tool available to the physicians at the Avera Heart Hospital actually allows them to see inside the walls of your blood vessels, which makes it easier for cardiologists to diagnose what needs to be done, the exact placement of a stent and if stent is fully expanded.
Dr. Tom Isaacson with North Central Heart is showing us why IVUS or Intravascular Ultrasound gives cardiologists the upper hand in the coronary catheter lab. A tiny camera mounted on the end of a catheter can take pictures of the artery wall where plaque builds up. It's fed up to the heart through the femoral artery in the leg, in the same fashion stents are placed to open blocked arteries.
Dr. Isaacson says, "You can look inside the vessel versus an x-ray picture from the angiogram. That picture uses dye, a shadow or outline, if you will, of the vessel. Intravascular ultrasound gives us a look at the vessel wall. We can see the size, shape and amount of plaque inside the vessel. IVUS allows us to examine much more critically."
Not everyone who comes in to the cath lab at the Avera Heart Hospital will require images from the ultrasound. Dr. Isaacson estimates only 20-25% of the cases do. He says, "It's really more for patients in the "grey area". Is the blockage severe enough to need stenting? Or if a stent was deployed is it positioned correctly, is it fully expanded to provide the maximum benefit."
Dr. Isaacson pointing to an image says, "Each bright spot is a place where the stent is. You can see here this should be pushed out further. So if we need to we can go back in with a larger balloon and correct it."
This new dimension in imaging, is once again, intended to keep more people off the operating table and away from open heart surgery and isn't nice to know its right at the fingertips of cardiologists at the Avera Heart Hospital.