• M Nomura, H Kurokawa, J Ishii, T Ando, M Ito, S Taga, Y Mori, H Naruse, and H Hishida.
• Department of Cardiology, Fujita Health University School of Medicine, Aichi.
• J Cardiol. 1999 Mar 1; 33 Suppl 1: 17-21.

AbstractEvaluation of the severity of coronary atherosclerosis by intracoronary imaging may be closely relevant with the prevention and treatment of acute coronary syndromes. Coronary angioscopy as one of the innovative methods of imaging and intravascular ultrasound makes the insight visualization of coronary vessel wall and histological recognition possible recently. Yellow plaques rich in lipid materials and covered by thin membrane are more often ruptured than white ones to cause acute coronary syndromes. In patients with unstable angina and acute myocardial infarction, the yellow plaques with intimal flaps and irregularities are frequently observed by angioscopy. Angioscopy is also the most powerful tool to detect intracoronary thrombus. In patients with acute myocardial infarction, thrombosis occludes vessel lumen totally, but it does not in the unstable angina cases. After thrombolytic therapy, the white thrombus is more often observed than the red one. Although angioscopy is superior to any other examination in diagnosing thrombosis, some complicated plaques are difficult to distinguish from thrombus. In addition to measurements of vascular dimension and plaque volume, histological diagnosis of plaque is being made by intravascular ultrasound. More precise evaluation of plaque histology may be a clue to predict the occurrence of acute coronary syndrome. Intravascular ultrasound is not so useful enough to diagnose thrombosis. In conclusion, the applications of intravascular imaging technologies, such as angioscopy and intravascular ultrasound, may play a critical role in the diagnosis and treatment of acute coronary syndromes.

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