Use of intravascular imaging in managing coronary artery disease

Table 1 Intravascular ultrasound criteria for optimal stent deployment

MUSIC criteria

Complete apposition of the stent over its entire length against the vessel wall

MLA:

In-stent MLA ≥ 90% of the average reference lumen area or ≥ 100% of the reference segment with the lowest lumen area

In-stent MLA of proximal stent entrance ≥ 90% of proximal reference lumen area

If the in-stent MLA is > 9.0 mm2:

In-stent MLA ≥ 80% of the average reference lumen area or ≥ 90% of the reference segment with the lowest lumen area

In-stent MLA of proximal stent entrance ≥ 90% of the proximal reference lumen area

Symmetric stent expansion defined by the minimum lumen diameter divided by the maximum lumen diameter ≥ 0.7

AVIO study criteria

Final minimum stent cross sectional area of at least 70% of the hypothetical cross sectional area of the fully inflated balloon used for post-dilatation

The optimal balloon size that should be used for post-dilatation is the average of the media to media diameters of the distal and proximal stent segments, as well as at the sites of maximal narrowing within the stent. The value is rounded to the lowest 0.00 or 0.50 mm. For values ≥ 3.5 mm, the operator could downsize the balloon diameter based on clinical judgment

MUSIC: Multicenter Ultrasound Stenting in Coronaries Study; MLA: Minimum lumen area; AVIO: Angiography vs IVUS Optimization; IVUS: Intravascular ultrasound.