1354.1 – Intravascular ultrasound guided coronary stent insertion

New MBS item.

The applicant has described that Intravascular Ultrasound (IVUS) is the generic name provided to any ultrasound technology that provides tomographic, three-dimensional, 360-degree images from inside the lumen of a blood vessel. During percutaneous coronary intervention (PCI), IVUS may be used to guide coronary stent insertion as an adjunct to angiography. IVUS, compared with angiography alone, is proposed to provide physicians with a better understanding of the atherosclerotic vessels, thus supporting appropriate treatment strategy, stent selection, stent placement, visualisation of stent apposition to the vessel, and adequate stent deployment to restore blood flow at the target site. The service therefore involves a therapeutic aspect and an investigative aspect. The proposed service in this Application is for the therapeutic use of IVUS during PCI for stent optimization.

Type: Therapeutic

The applicant states that the main underlying pathology in ischaemic heart disease (IHD) is atherosclerosis, which can lead to occlusion of the coronary arteries and oxygen starvation of the heart, which presents as acute coronary syndrome (ACS). ACS is the result of atheromatous plaques or endothelial disruption with associated transient or permanent thrombotic occlusion of the coronary vascular tree leading to unstable angina or myocardial ischaemia. When one or more of the coronary arteries are completely blocked, a myocardial infarction may occur. When the cerebral blood flow is compromised, IHD may result in stroke or cerebrovascular accident.

MSAC consultation closed 11 February 2022.

• PASC meeting: 15-16 April 2021
• ESC meeting: 10-11 February 2022
• MSAC meeting: 31 March-1 April 2022