How to IVUS

IVUS 123 Workflows can simplify IVUS use and help you optimize PCI results.

IVUS 123 Workflows

The IVUS 123 Workflows were developed in partnership with physicians to streamline the use of IVUS imaging in PCI procedures, getting you the most information in the fewest clicks. They provide a consistent approach to reviewing key clinical variables across a variety of case types.

Following IVUS 123 Workflows before and after intervention fosters standardized, evidence-based lesion assessment and stent optimization to help improve the reliability and durability of patient outcomes.

IVUS 123 Essentials

IVUS 123 Essentials workflows are imaging technology agnostic, standardized workflows to help an operator obtain and apply IVUS measurements and other information before and after intervention.

The workflows are supported by the body of clinical evidence that consistently shows the benefits of IVUS use, including:

74% strategy change in cases where IVUS is used¹

Supports selection of properly sized stents²

Improved patient outcomes driven by, among other factors, ensuring proper stent expansion³

Illustration showing the sideways angle of a lesion and its length

How to use IVUS 123 Essentials

Just three steps pre-PCI and post-stent placement give you access to key clinically significant information.

Pre-PCI workflow

Follow these three steps, in any order, to help determine treatment strategy.

Illustration showing the sideways angle of a lesion and the amount of plaque

Illustration showing the sideways angle of a lesion and how to gather distal, stenosis and proximal measurements

Post-stent workflow

Follow these three steps, in any order, to discover whether a stent deployed as planned. IVUS can help optimize patient results and improve the durability of patient outcomes.^1-3

Graphic showing geographic miss of a lesion, Graphic showing edge dissection of a lesion.

Top graphic is a lesion that is apposed and the lower graphic shows a malapposed lesion.

Illustration of a lesion where "a" shows the distal lumen reference, "b" shows the proximal lumen reference, and "c" shows under-expansion.

IVUS 123 + Automated Lesion Assessment (ALA™)

For operators who are ready to explore AI features, IVUS 123 + ALA takes the IVUS 123 ESSENTIALS workflow to the next level. ALA uses machine learning to automatically provide key measurements, diameters, and borders, ensuring you have the details needed to quickly and confidently plan and perform procedures.

Interested in learning more about how ALA outputs compare to the experts? See a discussion of findings from an independent research study published in early 2025. The video is part of our Heart Expert Series.

Other IVUS resources

Screenshot of the IVUS Series map in EDUCARE.

Online IVUS education

The EDUCARE online learning platform offers the IVUS Series with interactive educational modules plus additional PCI training content.

Explore the IVUS Series

IVUS clinical data

Major studies demonstrate that incorporating IVUS throughout PCI procedures enables treatment optimization.^1-3

See the evidence

IVUS image library

Explore high-definition IVUS images showing a variety of disease states to advance your interpretation skills.

Browse the IVUS library

1. Lee, JM, Choi, KH, Lee, JY, et. Al. Intravascular Imaging-Guided or Angiography-Guided Complex PCI. N Engl J Med 2023; 388:1668-1679. doi: 10.1056/NEJMoa2216607

2. Li X, Ge Z, Kan J, et al. Intravascular ultrasound-guided versus angiography-guided percutaneous coronary intervention in acute coronary syndromes (IVUS-ACS): a two-stage, multicentre, randomised trial. Lancet. 2024;403(10439):1855-1865. doi:10.1016/S0140-6736(24)00282-4

3. Hong SJ, Zhang JJ, Mintz GS, et al. Improved 3-Year Cardiac Survival After IVUS-Guided Long DES Implantation: A Patient-Level Analysis From 2 Randomized Trials. JACC Cardiovasc Interv. 2022;15(2):208-216. doi:10.1016/j.jcin.2021.10.020

4. Zhang J, Gao X, Kan J, et al. Intravascular Ultrasound Versus Angiography-Guided Drug-Eluting Stent Implantation: The ULTIMATE Trial. J Am Coll Cardiol Intv. 2018;72(24):3126-3137. doi: 10.1016/j.jacc.2018.09.013

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