An intravascular echocardiogram (also called intravascular ultrasound or IVUS) is a minimally invasive procedure performed as part of a cardiac catheterization. It may be performed if a standard echocardiogram has revealed a possible problem, but the test did not provide enough information to be conclusive. It is one of the most accurate tests in the diagnosis of coronary artery disease.

This test is performed using a thin tube called a catheter, which is fed through a blood vessel to a part of the body that needs to be assessed. The catheter is inserted through a very small incision in the groin, arm or wrist. Through this catheter, a transducer is guided up through the blood vessel to the heart. The echocardiogram is then performed along with a variety of other measurements.

People who are scheduled for a cardiac catheterization are encouraged to arrange for transportation home from the test, because they will be given a sedative that may leave them feeling groggy or light-headed.

Physicians generally advise their patients to reduce or stop taking medications that affect blood clotting (anticoagulants and antiplatelets) prior to this test. On the morning of the test, patients may be told to fast or eat only a light breakfast.

Just before the test, a sedative is given through an intravenous (IV) solution and the area of the incision site where the catheter will enter the blood vessel is numbed with a local anesthetic. The test is then performed, and after some recovery time (about six hours), most patients are free to go home. Instructions regarding exercise and exertion, care of the incision area and the use of medications will vary depending on the patient.

The risk of complications during this procedure is very low.