Role of Intravascular Ultrasound in the Detection of Cardiovascular Disease in Diabetes and Metabolic Syndrome in Latin America

Purpose of Review: Intravascular ultrasound (IVUS) is an essential tool in the cardiac cath lab, providing tomographic slices series of intra-luminal and vascular wall images with high quality and spatial resolution, that complement angiographic luminal information. It has been successfully used in research for the understanding of atherosclerotic process, and it was the first clinical method that delineated diverse patterns of atherosclerosis. IVUS also contributed to the advancement in the knowledge of restenosis after percutaneous coronary interventions (PCI). Recent Findings: Routine clinical of IVUS is hindered in most Latin American countries due to lack of reimbursement. In comparison with the rate of IVUS utilization around 5 % in the USA and of 5 % in Europe, the rate is less than 1 % in Latin America. These low rates occur despite the fact that the European, American, and Brazilian guidelines agreed regarding IVUS utilization in specific clinical settings: assessment of non-left main intermediate lesions as evaluated by angiography, assessment of angiographically uncertain severity of left main coronary artery disease, and as a guidance to optimization of coronary stent implantation. Summary: In this review, we emphasize the importance of IVUS as a research tool in selected patients with coronary heart disease, especially those treated with PCI, particularly in diabetic patients, and also discuss some data that support its routine clinical use. © 2016, Springer Science+Business Media New York.