Intravascular Imaging for Venous Interventions

Purpose of Review: This review surveys the clinical landscape of intravascular imaging for endovenous interventions. Recent Findings: Endovascular imaging has become increasingly important for diagnosing venous pathology and guiding venous interventions. In particular, intravascular ultrasound (IVUS) provides 3D high-resolution cross-sectional imaging of vessel and surrounding tissues, often in anatomic locations inaccessible to surface ultrasound, namely the superior vena cava, inferior vena cava, and caval-iliac veins. Summary: Current well-established indications for venous IVUS include diagnostic studies, venoplasty, transjugular intrahepatic portosystemic shunt (TIPS) creation, inferior vena cava filter placement, and transjugular liver biopsy. In the future, optical coherence tomography may play an increasing role in venous assessment and intervention.