IVUS is a promising technique for the evaluation of venous stenoses that is superior to single-plane venography. It allows the detection of lesion morphology and degree of stenosis (Figure 3). Neglen et al compared the use of IVUS to venography for the evaluation of patients with venous outflow obstruction. In this study, they found that venography underestimated stenosis by 30%. In addition, they reported that venography was considered normal in one-fourth of limbs despite the fact that IVUS showed more than 50% of obstruction. IVUS shows intraluminal details, trabeculations, and webs that may be hidden by the contrast dye. Other advantages of IVUS are its ability to demonstrate external compression directly, wall thickness, and neointimal hyperplasia. To date, IVUS seems to be the best available method for diagnosing clinically significant chronic iliac vein obstruction. http://bmctoday.net/evtoday/2009/07/art ... 709_06.php
When it compares IVUS to venography, I assumed it means catheter venography. If so, the percentages here (30% underestimation of stenosis if IVUS isn't used, 25% of limbs seen as normal with regular venography have obstruction when seen with IVUS) are impressive.
This is a tool we want in our IR's toolboxes. It is also an expensive tool that adds time to the procedure. It also takes some expertise to use correctly.
I bolded the part that fits with what Dr. Zamboni recently said:
cheerleader wrote:"CCSVI is composed of several blockages in the main outflow routes, the jugular vein, azygous vein, but this is very important to understand," he said, displaying angiographic and high-resolution B-mode images along with a specimen, these blockages "are merely intraluminal defects; not problems in the wall, but intraluminal defects: webs, membranes, malformed valves."