Boston Scientific builds intravascular ultrasound into labs

If the future of ultrasound is integration, the industry drew a step closer this week with the global launch of Boston Scientific Lab's intravascular ultrasound system. The product, billed as the first of its kind, can be installed directly into a cardiac cath lab or radiology suite, allowing doctors to incorporate IVUS technology into their daily workflow, visualizing the heart as well as coronary and peripheral vasculature.

The increasing popularity of drug-eluting stents and other technologies for unclogging blood vessels underscores the need for precise cardiovascular information. IVUS helps provide this information through improved visualization of the heart and blood vessels and by quantifying disease.

But a barrier to routine use of IVUS has been its lack of user friendliness, or what Jeff Bennett, senior product manger for imaging at Boston Scientific, calls "the hassle factor." Making the system part of the procedure lab and putting controls into the hands of physicians addresses this issue.

"We are positioning the IVUS system as being ready when the physician is," Bennett said. "The tech comes into the lab, turns on the system, and it is ready all day long. The physicians don't have to wait for iLab to be found and brought into the room and booted up."

Although cleared in September 2005 by the FDA, Boston Scientific delayed commercial launch of the product to allow engineers time to fine-tune the unit based on feedback from clinical sites around the world. The system is now shipping in the U.S., Europe, and much of Asia Pacific, except Japan, he said.

Customers can choose from several integration modes. The product can be wired into a dedicated monitor in the procedure room, with cabling run through the ceiling or wall to a control room where the hardware is housed. Alternatively, this hardware can be wired into a monitor mounted on an imaging system boom. It can also be designed for use as one of the panels on an existing monitor, as in the case of the six- or eight-panel monitor that typically comes with cardiac cath or angio systems.

A tableside controller provides a touch panel in the sterile field with prompts that correspond to particular stages of the procedure. A dynamic review feature enhances image interpretation by creating cine loops of frames acquired immediately before and after the point where the intervention is being planned. Seeing blood flow in this loop helps distinguish the static images of lumen and plaque, Bennett said.

Integrating iLab with the cath lab and angio suite is a step toward making IVUS a part of the mainstay imaging chain, now dominated by x-ray, whereby imaging data can be shared between the modalities, Bennett said.

"We are not at that point yet, but it is a major step toward the future integration that we want to do," he said.