Intracoronary ultrasound, angioscopy and angiography in the study of plaque morphology and the mechanisms of action of coronary interventions

Investigation of the characteristics of the atheromatous plaque has gained new interest since the advent of pharmacological and mechanical intervention in the coronary arteries. Most of the information available on plaque substrate and its modification by such interventions was based in pathological or angiographic studies. However, major bias occurs when these sources of knowledge are used. Post-mortem studies afe performed only in those patients with the extreme of the clinical manifestations of a syndrome and a faral outcome, or in cases where death occurred as a consequence of failed intervention. On the other hand, angiography constitutcs a "shaclowgram» or luminogram which provides limited insights on the nature of coronary obstruction, and no infonnation as to the characteristics of the arterial wall and. Catheter based intracoronary imaging techniques provide a major opportunity to solve the above discllssed limitations. Intracoronary ultrasound and angioscopic imaging provide complementary information as to the structure and composition of the arterial wall and the modifications in the luminal surface of the coronary arteries.

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