The Role of Intravascular Ultrasound (IVUS) In Guiding Interventions for Patients with Aberrant Coronary Arteries: A Comprehensive Review

Aberrant coronary arteries present unique challenges in diagnostic and interventional cardiology due to their atypical anatomy, high variability, and potential association with adverse cardiac events. Intravascular ultrasound (IVUS), as an intraluminal imaging modality, has emerged as a critical tool in guiding interventions in this subset of patients. IVUS provides high-resolution cross-sectional images of vessel morphology, allowing precise assessment of luminal dimensions, plaque burden, and stent positioning, especially in anatomically complex regions where conventional angiography falls short. This review explores the utility of IVUS in the evaluation and management of aberrant coronary arteries, highlighting its role in minimizing complications, optimizing procedural outcomes, and advancing our understanding of these rare but clinically significant anomalies. We also discuss the integration of IVUS with adjunctive imaging modalities, technical considerations, and future perspectives in the field.