Intravascular ultrasound has been shown to provide a useful perspective during percutaneous balloon angioplasty. Before intervention, intravascular ultrasound has been used to discriminate fibrous from calcified plaques and concentric from eccentric lesions. Following procedures, intravascular ultrasound has accurately detected the presence of dissections and plaque fractures, and has shown that in such cases luminal enlargement after transluminal balloon angioplasty is produced by stretching of the arterial wall while the volume of the lesion remain constant.
In addition to specific plaque characteristics, several other variables, such as luminal thrombus, extensive dissection, over- or undersized balloons, and concentricity of lesions, have been associated with an increased risk of both early and late restenosis. All of these factors are identified by intravascular ultrasound, which illustrates the potential of intravascular ultrasound for enhancing percutaneous transluminal angioplasty.