Video

LINC 2020: IVUS vs Fluoroscopic Guided Recanalization for Iliofemoral Obstruction

Published: 10 Feb 2020

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Dr Michael Lichtenberg (Vascular Centre Clinic Arnsberg, Arnsberg, DE) discusses IVUS vs fluoroscopic guided recanalization for iliofemoral obstruction. 
 
Questions
2. How and why did you conduct this study?
4. Is IVUS a viable alternative to fluoroscopic guided recanalization?
5. What further investigation needs to be conducted to follow up this information?
6. How should this information impact clinical practice?
 
Filmed on location at the Leipzig Interventional Course 2020. 
 
Interviewer: David Ramsey
Videographer: Natascha Wienand
 

Transcript Below : 

Question 1 : How and why did you conduct this study?

Patients with venous outflow obstructions are very young patients usually, and we need not only to think of efficacy to treat these patients properly, we also need thinking about safety. And safety means we need to discuss how can we reduce radiation exposure and this retrospective analysis aimed to focus what are the possibilities to reduce radiation exposure during venous intervention? 

Question 2 : Is IVUS a viable alternative to fluoroscopic guided recanalization?

That's not definitely an alternative, it's a very good additional tool and it can take over some of the parts we are taking of the fluoroscopic analysis. So, you can't do the intervention just on IVUS-guided, you need some kind of fluoro, but with combination of these diagnostic modalities, IVUS and angiography, you can definitely reduce the radiation exposure. 

Question 3 : What further investigation needs to be conducted to follow up this information?

So, this was a single-center study with retrospective data. Even that, we included 228 patients, it's always good to have prospective data and the next step would be to set up a prospective multicenter study to really analyse and more objectively analyse the data and find out the significant evidence for using IVUS in this particular field. Based on efficacy, we already know that IVUS is absolutely a helpful tool for deep venous interventions, so this is a clear statement, so far. 

Question 4 : How should this information impact clinical practice?

Based on safety, it is now getting clear that IVUS helps to reduce radiation exposure, but again, as I said, we need to set up a prospective trial to really answer that question.