• Maxim Mokin, Peter Kan, Adib A Abla, Tareq Kass-Hout, Kenneth V Snyder, Elad I Levy, and Adnan H Siddiqui.
• Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York, USA; Department of Neurology, Gates Vascular Institute, Kaleida Health, Buffalo, New York, USA.
• World Neurosurg. 2013 Nov 1;80(5):655.e7-13.

BackgroundIntravascular ultrasound (IVUS) is an important diagnostic tool in many interventions, particularly coronary and carotid artery angioplasty and stenting. In contrast, its application in the management of diseases of the cerebral venous system remains an unexplored territory. We report three patients in whom IVUS was used during angiography for the evaluation of venous flow obstruction secondary to venous sinus thrombosis, venous sinus stenosis, and a transverse sinus mass lesion, respectively. In addition, we review current literature to summarize previous experience, focusing on the advantages and limitations of IVUS technology in interventional cardiology, carotid artery disease, and venous disease.Case DescriptionsIn all three cases, IVUS was used without any complications and provided critical information that guided further management of these distinct diseases. IVUS helped diagnose the presence of intraluminal thrombus, severe stenosis, and a mass lesion in the transverse sinuses and also helped assess the response to angioplasty of the stenotic regions.ConclusionsIVUS is a promising tool that has potential to improve diagnostic accuracy and to guide the management of several diseases of the cerebral venous system. The cases we describe suggest that IVUS can be successfully used when performing endovascular interventions in patients with obstruction of venous outflow secondary to venous sinus stenosis, thrombosis, or mass lesions.Copyright © 2013 Elsevier Inc. All rights reserved.

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