ABSTRACT
Recently developed intravascular imaging techniques can reveal information about coronary atherosclerosis beyond that provided by traditional angiography. Grayscale intravascular ultrasound (IVUS) is a widely accepted catheter-based diagnostic tool that allows assessment of plaque area, plaque distribution, lesion length, and coronary remodeling. When combined with spectral analysis of radiofrequency data, IVUS enables a more detailed analysis of plaque composition. Coronary angioscopy permits direct visualization of both the coronary artery lumen and wall. Therefore, angioscopy is the most reliable tool for detecting intraluminal thrombus, while diagnosis of thrombus by other imaging techniques is considered presumptive. Optical coherence tomography is a high-resolution imaging technique that allows excellent characterization of atherosclerotic plaques. Although this technique is limited by a shallow depth of penetration, its higher resolution with respect to IVUS has the ability to detect thin-cap fi broatheroma. Given the complementary information acquired from diverse imaging modalities, a combination of techniques may represent the optimal approach to a comprehensive evaluation of coronary atherosclerosis.
