Three-dimensional intravascular ultrasound analysis of coronary stent deployment and in-stent neointimal volume: Current clinical practice and the concepts of TRAPIST, ERASER, and ITALICS

Intravascular ultrasound (IVUS) permits the detailed examination of coronary stent apposition and expansion in vivo. IVUS assessment of the extent and distribution of in-stent neointima at follow-up is an ideal model for the evaluation of new antiproliferative drugs that aim at a reduced in-stent neointimal hyperplasia. Recently, automated systems for three-dimensional reconstruction and analysis of IVUS images have been developed. This manuscript illustrates the methodology and clinical use of automated three-dimensional IVUS analysis systems during coronary stenting, and highlights the first randomized trials to apply such a technique for the assessment of in-stent neointima.