Mapping Intravascular Ultrasound Controversies in Interventional Cardiology Practice

Mapping Intravascular Ultrasound Controversies in Interventional Cardiology Practice

Maresca, D.
Adams, S.
Maresca, B.
Van der Steen, A.F.W.

Applied Sciences

ImPhys/Imaging Physics

2014-05-09

Intravascular ultrasound is a catheter-based imaging modality that was developed to investigate the condition of coronary arteries and assess the vulnerability of coronary atherosclerotic plaques in particular. Since its introduction in the clinic 20 years ago, use of intravascular ultrasound innovation has been relatively limited. Intravascular ultrasound remains a niche technology; its clinical practice did not vastly expand, except in Japan, where intravascular ultrasound is an appraised tool for guiding percutaneous coronary interventions. In this qualitative research study, we follow scholarship on the sociology of innovation in exploring both the current adoption practices and perspectives on the future of intravascular ultrasound. We conducted a survey of biomedical experts with experience in the technology, the practice, and the commercialization of intravascular ultrasound. The collected information enabled us to map intravascular ultrasound controversies as well as to outline the dynamics of the international network of experts that generates intravascular ultrasound innovations and uses intravascular ultrasound technologies. While the technology is praised for its capacity to measure coronary atherosclerotic plaque morphology and is steadily used in clinical research, the lack of demonstrated benefits of intravascular ultrasound guided coronary interventions emerges as the strongest factor that prevents its expansion. Furthermore, most of the controversies identified were external to intravascular ultrasound technology itself, meaning that decision making at the industrial, financial and regulatory levels are likely to determine the future of intravascular ultrasound. In light of opinions from the responding experts', a wider adoption of intravascular ultrasound as a stand-alone imaging modality seems rather uncertain, but the appeal for this technology may be renewed by improving image quality and through combination with complementary imaging modalities.

http://resolver.tudelft.nl/uuid:d2aaedb2-d9d7-4a3f-a158-9c0d8e78a88e

https://doi.org/10.1371/journal.pone.0097215

Public Library of Science

1932-6203

http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0097215

PLoS ONE, 9 (5), 2014

Institutional Repository

journal article

© 2014 The Author(s)
This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.