What is the purpose of intravascular ultrasound (IVUS) in PCI optimization?

• A. To assess vessel size, lesion morphology, stent expansion and apposition
• B. To measure heart chamber pressures
• C. To evaluate coronary flow reserve
• D. To image the aorta

Answer: (C)

IVUS during PCI gives real-time, inside-the-artery images that let you measure the true vessel size, understand lesion morphology, and verify how a deployed stent expands and seats against the vessel wall. This direct visualization is what you rely on to optimize PCI: you can choose the correct stent size, detect bulky or complex plaque that might hinder full expansion, and confirm that the stent is well apposed to prevent gaps where thrombus or restenosis could develop. Because of this, IVUS is a key tool for achieving durable stent results.

Other measurements aren’t the primary role of IVUS. Measuring heart chamber pressures is done with pressure wires and invasive hemodynamic assessment, not IVUS imaging. Coronary flow reserve is evaluated with Doppler techniques or pressure-derived indices like FFR, not IVUS cross-sectional imaging. Imaging the aorta is typically accomplished with CT, MRI, or echocardiography rather than IVUS.