Available online 5 August 2023, 100898

As the field of Vascular and Interventional Radiology continues to grow, the variety of pathology treated, the approaches to treating various disease processes, and the vast options of equipment and devices continue to grow as well. Numerous venous disease processes have now become commonplace within the treatment realm of interventional radiologists and knowing how to approach each disease process is critical to successful management of these complex patients. A few of the most encountered venous disease processes include pelvic venous disorders, vena cava tumor involvement, venous thrombosis, and inferior vena cava filter placement; an understanding of the management of these processes is integral to the practice of today's interventional radiologists. Intravascular ultrasound (IVUS) has become increasingly important both in the diagnosis and in guiding treatment for venous disease. This article will describe in detail the multiple ways that IVUS can be used in the treatment of complex venous disorders.

IVUS was initially developed and pioneered by Dr. Yock in the late 1980s and consists of a tiny ultrasound probe based at the distal end of a catheter that allows for 360-degree characterization of the vessel wall as well as a limited view of the anatomy surrounding the vessel 1. Initial use of IVUS was tailored towards arterial disease including coronary atherosclerosis and helped overcome the limitations of normal angiography. It can aid in evaluation of lesion severity and plaque

Intravascular ultrasound has become an essential tool for the treatment of many disease pathologies. It is crucial both for accurate diagnosis and to guide therapies for many critically ill patients with venous thrombosis as well as venous compression disorders. Furthermore, IVUS can be used for portal and superior vena cava interventions as well. The authors highly recommend the use of IVUS for improved evaluation and treatment of numerous venous pathologies.

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