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At least 613 records · Page 34Linked to original sources
PubMed2002

Optimizing the beam pattern of a forward-viewing ring-annular ultrasound array for intravascular imaging.

Intravascular ultrasound (IVUS) imaging systems using circumferential arrays mounted on cardiac catheter tips fire beams orthogonal to the principal axis of the catheter. The system produces high resolution cross-sectional images but must be guided by conventional angioscopy. A real-time forward-viewing array, integrated into the same catheter, could greatly reduce radiation exposure by decreasing angiographic guidance. Unfortunately, the mounting requirement of a catheter guide wire prohibits a full-disk imaging aperture. Given only an annulus of array elements, prior theoretical investigations have only considered a circular ring of point transceivers and focusing strategies using all elements in the highly dense array, both impractical assumptions. In this paper, we consider a practical array geometry and signal processing architecture for a forward-viewing IVUS system. Our specific design uses a total of 210 transceiver firings with synthetic reconstruction for a given 3-D image frame. Simulation results demonstrate this design can achieve side-lobes under -40 dB for on-axis situations and under -30 dB for steering to the edge of a 80 degrees cone.

Blood Vessels↗
PubMed1992

Percutaneous angioplasty of chronic obstruction of peripheral arteries by a temperature-controlled Nd:YAG laser system.

The feasibility of an Nd:YAG laser system with automatic control of hot-tip probe temperature was examined in 15 segments (14.7 +/- 6 cm in length) of iliofemoral arteries from 13 patients. The hot-tip temperature to be attained and the upper limit temperature at which lasing was to be stopped were preset. A catheter with a 1.8-mm hot-tip probe was introduced into the obstructed segment and angioplasty (lasing time 5-10 sec) was performed under angioscopic guidance. Recanalization was observed in all segments without obvious complications. No thermal effects below 50 degrees C, coagulation at 100 degrees C, carbonization at 200 degrees C, or sticking of the hot-tip to the luminal surface at 300 degrees C or over, were observed by angioscopy. Rapid recanalization was obtained between 200 degrees C and 300 degrees C. The results indicate that this novel laser system is feasible and hot-tip temperature between 200 degrees C and 300 degrees C is ideal for treatment of chronic arterial obstruction in Japanese patients.

Aged↗
PubMed1994

Statistical analysis of invasive cardiology for Austria in 1992 as an approach to quality assessment.

Quality Control in Interventional Cardiology requires perfect documentation. We, therefore, report a mutual controlling system, which has been initiated in Austria 3 years ago. An all round inquiry within all the 28 Austrian catheterization laboratories was successful with a feedback rate of 100%, controlled by visiting the centers, random tests, and several phone calls. This year was the first time that an entire European country followed the guidelines for statistical documentation that the European Society of Cardiology has suggested. Within the year 1992, 3,780 percutaneous coronary angioplasties were performed in Austria, which is 19.7% more, compared to the year before. At the same time 18,806 coronary angiographies, 102 percutaneous valvuloplasties, and 138 electrophysiological ablations took place. Austria reached 84% of the number of angiographies and 50% of the percutaneous transluminal coronary angioplasty (PTCA) numbers, the World Health Organization (WHO) has provided for a country of 7.82 million inhabitants. One hundred and fifty-two "new devices" (stent/n = 89, atherectomy/n = 44, laser/n = 6, etc.) were used during this year, which was 4.0% of all PTCA procedures. Angioscopy (n = 11) and intracoronary ultrasound (n = 82) accounted for another 2.5% of "new devices". Complication rate was 0.48% hospital deaths, 0.93% emergency bypass surgery, and 1.88% myocardial infarction in 3,780 PTCAs. The individual data of each center were treated confidentially and anonymously and the evaluated questionnaire was sent back to the respective center only, including an individual recommendation for quality improvement.(ABSTRACT TRUNCATED AT 250 WORDS)

Angiography↗
PubMed2001

Angioscopic evaluation of the effect of estrogen on ovariectomized Japanese monkeys.

Using angioscopy to study the atheroprotective effect of estrogen, atherosclerotic changes in surgically postmenopausal Japanese monkeys were observed for a long period. Changes in serum lipids and estradiol were also followed. About 3-6 months after the 2% cholesterol diet, serum cholesterol increased up to three times normal value, and atheroma was first found at the orifice of major branches of the abdominal aorta. However, in the other group of 2% cholesterol including an oral estrogen diet, the appearance of atheroma was inhibited until 12 months, although serum cholesterol increased gradually. The chronologic investigation was continued over 3 years. From these results we concluded that the most important atheroprotective effect of estrogen is the direct inhibition of atherosclerosis in the arterial wall, and improvement in lipid metabolism is of secondary importance.

Animals↗
PubMed2003

Imaging of high-risk plaque.

'High-risk' or 'vulnerable' plaques in the coronary arteries have characteristics that make them more prone to disruption and subsequent thrombosis -- the mechanisms of most acute coronary syndromes (ACS). There are a number of imaging modalities that are capable of visualizing these features. This article discusses invasive modalities for identifying 'high-risk' plaque such as intravascular ultrasound, coronary angioscopy, optical coherence tomography, near-infrared spectroscopy and coronary thermography. It also discusses the use of noninvasive modalities such as computed tomography MRI and ultrasound. When these imaging modalities are combined with standard cardiac risk factors and more novel markers of systemic inflammation and thrombogenicity we can improve our ability to identify the 'high-risk' patient.

Coronary Artery Disease↗
PubMed1990

Insights into the pathogenetic mechanisms of unstable angina.

Patients with unstable angina and/or non-Q-wave infarction constitute a group that is at high risk for progression to acute myocardial infarction or sudden death. Furthermore, in spite of maximal medical therapy, a large fraction of these patients experience recurrent episodes of myocardial ischemia prompting surgical revascularization or coronary angioplasty. In prior studies of patients with unstable angina, the incidence of myocardial infarction within 1 month of hospitalization was 8-13%, and the incidence of death was about 4%. Between 3 months and 1 year after presentation, the cumulative rate of infarction or death increased to 10-14 and 8-10%, respectively. That is, most recurrent ischemic events occur within the first 3 months after the onset of symptoms. In the subset of patients with pain at rest or with electrocardiographic changes at the time of admission, the prognosis is even worse. The rate of myocardial infarction or death in such patients ranged between 14 and 21% during the first 3-4 months after onset of symptoms. Crossover to surgical therapy because of recurrent ischemic pain was also common, occurring in 30-50% of the patients at 3 months. Recent advances in understanding the pathophysiology of these two syndromes suggest that an aggressive antithrombotic regimen could be of great benefit in preventing progression to acute coronary occlusion and death. Pathologic investigations strongly suggested that plaque fissuring and subsequent overlying thrombosis were the major components in the process of unstable angina progressing to myocardial infarction and/or sudden death. This hypothesis has been substantiated by recent pathologic studies of patients who died shortly after the onset of unstable angina. Examination of the coronary arteries revealed not only plaque fissuring with superimposed layers of thrombus in the majority of the cases, but also evidence of distal thromboembolism from these foci. In vivo coronary arteriography in patients with unstable angina highlighted the progression of prior coronary stenoses, even to total occlusion, and the eccentric and irregular angiographic morphology of the ischemia-producing lesions. Furthermore, intracoronary thrombus is often seen at these sites, especially when arteriography is carried out soon after rest pain. These observations also suggested that plaque rupture may have occurred. Intraoperative angioscopy has revealed ruptured plaques in patients with progressive unstable angina, while those with rest pain had complicating thrombi. Patients with unstable angina also have biochemical evidence of activation of both the coagulation systems and platelets.(ABSTRACT TRUNCATED AT 400 WORDS)

Angina, Unstable↗
PubMed2004

Finding vulnerable atherosclerotic plaques: is it worth the effort?

Techniques to identify and treat vulnerable plaques are the focus of enormous research. Some have questioned the benefit of locating individual vulnerable plaque in a multifocal disease. On autopsy, it is found that most deaths are caused by thrombotic occlusion of a single plaque; simultaneous occurrence of 2 occlusive thrombi is rare, but a second vulnerable plaque is common, particularly in acute myocardial infarction (MI). Angiographic progression is poorly predicted by risk factors, and angiographic progression is a weak predictor of MI or death. Intravascular ultrasonography (intravascular ultrasound [IVUS]) studies find plaque rupture in most MI patients and in approximately half with unstable angina, but in only a minority of patients with stable angina. IVUS identifies a second vulnerable plaque in many patients with unstable angina, and in most MI patients. Angioscopy reveals a very low incidence of a second vulnerable plaque compared with angiography and IVUS, but identifies additional yellow plaques in many patients with stable angina and in most patients with unstable angina or MI. Using thermography catheters and a temperature cutoff of 0.1 degrees C, approximately half the patients with stable angina have >1 hot lesion; however, if the cutoff is 0.2 degrees C, only approximately 15% have a second hot lesion. New imaging techniques may detect additional characteristics of plaques and new predictive models may assess the risk of vulnerable plaques and patients. This approach enables physicians to "buy time" by application of local therapies until systemic therapies stabilize plaques. This may also reduce the risk in subjects in whom systemic therapies do not work.

Animals↗
PubMed1995

Do patients with primary pulmonary hypertension develop extensive central thrombi?

BACKGROUND: Distinguishing chronic major vessel thromboembolic pulmonary hypertension from primary pulmonary hypertension is critical because the treatment options differ markedly. Surgical thromboendarterectomy is potentially curative in the former condition, whereas oxygen, vasodilators, perhaps anticoagulation, and lung transplantation are the options for the latter. The development of large thrombi in the main, right, or left pulmonary arteries has not been previously described in patients with primary pulmonary hypertension. METHODS AND RESULTS: Three pulmonary hypertensive patients with massive thrombi in the central pulmonary arteries are described. The data indicate that the large central thrombi in these three patients were not hemodynamically significant. In none did perfusion lung scans demonstrate segmental or larger defects. CONCLUSIONS: Large central thrombi can develop in patients with primary pulmonary hypertension. Perfusion lung scans that do not demonstrate segmental or larger defects should alert physicians to this possibility. Chest computed tomography and other studies identifying such thrombi are not adequate in distinguishing such a development from operable chronic major vessel thromboembolic hypertension. Careful review of lobar and segmental artery findings and the pulmonary angiogram, angioscopy, and cardiac catheterization data demonstrating the hemodynamic significance (or lack thereof) of these thrombi are essential in making this important distinction. Furthermore, these observations may constitute an additional indication for anticoagulant therapy in primary pulmonary hypertension.

Adult↗
PubMed2005

Distal protection improved reperfusion and reduced left ventricular dysfunction in patients with acute myocardial infarction who had angioscopically defined ruptured plaque.

BACKGROUND: Distal protection, in the Saphenous Vein Graft Angioplasty Free of Emboli (SAFER) trial, is demonstrated to prevent distal embolism in the percutaneous coronary intervention of saphenous vein graft. However, in the Enhanced Myocardial Efficacy and Recovery by Aspiration of Liberated Debris (EMERALD) trial, it was not effective in the percutaneous coronary intervention of native coronary arteries in patients with acute myocardial infarction (AMI). We hypothesized that its effectiveness would be determined by lesion characteristics. Therefore, we classified the type of culprit lesion by angioscopy and examined its influence on the effectiveness of distal protection, comparing patients with AMI treated with and without distal protection. METHODS AND RESULTS: Consecutive patients with AMI treated without distal protection (n=110) from July 2000 to July 2002 and those treated with distal protection (n=81) from July 2002 to July 2004 were included. Patients in each group were subdivided according to whether or not they had angioscopically defined ruptured plaque at culprit lesion. Among those groups, incidence of no-reflow phenomenon, ST-segment resolution, myocardial blush grade, and left ventricular ejection fraction at 6 months were compared. Aspirated samples by distal protection were semiquantitatively and histologically analyzed and compared between patients with and without ruptured plaque. No-reflow phenomenon was most frequently (P<0.05) observed in patients with ruptured plaque treated without distal protection. ST-segment resolution (68+/-15% versus 40+/-21%, P<0.001), myocardial blush grade (2.6+/-0.5 versus 1.8+/-0.3, P<0.001), and left ventricular ejection fraction (47.2+/-6.7% versus 41.0+/-9.7%, P<0.01) were improved by distal protection among patients with ruptured plaque but not among patients without ruptured plaque. Aspirated samples >1 mm were detected more frequently (97.3% versus 78.5%, P<0.05) in patients with ruptured plaque than those without ruptured plaque. Histologically, aspirated samples contained plaque debris (95.3% versus 31.1%, P<0.05) more frequently in patients with ruptured plaque than in those without ruptured plaque. CONCLUSIONS: Distal protection reduced microcirculation damage and left ventricular dysfunction in patients with AMI who had angioscopically defined ruptured plaque. Distal embolization of plaque debris was detected more frequently in patients with ruptured plaque. These results suggest that microcirculation damage and left ventricular dysfunction are increased mainly by distal embolization of plaque debris rather than of thrombus.

Biopsy, Needle↗
PubMed2002

Heparin-coated versus uncoated Palmaz-Schatz stent in native coronary circulation. A randomized study with blind angioscopic assessment.

UNLABELLED: The increasing use of stenting to treat more complex lesions and highly thrombogenic situations still carries higher risk for subacute stent thrombosis. To assess new heparin-coated stents in a more stringent reality, 40 consecutive patients were randomized in 1:1 ratio to receive either heparin-coated (group 1, 25 stents) or uncoated Palmaz-Schatz stents (group 2, 32 stents). The two groups were similar in baseline clinical, pre-and post-procedural angiographic and angioscopic characteristics. High pressure stent deployment without intravascular ultrasound guidance was used. All pts received antiplatelet agents alone. We applied serial angioscopy (baseline and on 7th day) to evaluate thrombus formation and quantitative coronary angiography (QCA) to define late (6 months, n=39, 100% the eligible pts) neointimal regrowth. There was one subacute stent thrombosis with subsequent acute myocardial infarction and death in the uncoated group. CONCLUSION: The implantation of heparin-coated stents in nonselected population is well tolerated and associated with no clinical or angioscopic evidence of new thrombus formation, resulting in favorable long-term clinical and angiographic outcome.

Anticoagulants↗
PubMed2001

Arterial thrombus dissolution in vivo using a transducer-tipped, high-frequency ultrasound catheter and local low-dose urokinase delivery.

PURPOSE: To examine the hypothesis that a transducer-tipped high-frequency ultrasound drug-delivery catheter may augment the thrombolytic effects of locally delivered low-dose urokinase and result in improved recanalization rates and reduced residual thrombotic burden. METHODS: Thrombi were induced in situ bilaterally in 5- to 6-cm-long segments of the superficial femoral arteries in 9 dogs by intraluminal thermal damage and injection of thrombin. A transducer-tipped high-frequency local drug-delivery catheter was applied at 1.1 MHz and 0.6 W for 60 minutes to one superficial femoral artery segment, and an identical catheter with an inactivated ultrasound transducer was used to treat the contralateral control segment. Urokinase (5000 IU/kg) was delivered bilaterally into the thrombi during the treatment interval. RESULTS: Angiography documented TIMI grade 2 or 3 flow in 9 (100%) segments in the ultrasound-treated group versus 6 (67%) of the controls (no ultrasound) (p = 0.058). Angiographically detected distal embolization was found in 2 ultrasound-treated segments compared with 5 controls (p = 0.02). Protruding or occlusive thrombi were seen angioscopically in 8 (89%) control segments but in only 1 (11%) of the ultrasound-treated arteries (p < 0.001). By histopathology, 7 (78%) segments in the control group had occlusive thrombi, whereas only 3 nonocclusive thrombi were found in the ultrasound-treatment group (p < 0.001). CONCLUSIONS: Catheter-delivered high-frequency ultrasound and local low-dose urokinase infusion is efficacious for the treatment of acute thrombotic occlusions as evaluated by angiography, angioscopy, and histopathology.

Animals↗
PubMed2002

Trends in endovascular surgery training.

PURPOSE: To gather vascular surgery fellows' opinions on various issues related to endovascular surgery (EVS) over a 2-year period and analyze the responses to identify trends in EVS training. METHODS: Vascular surgery fellows in 2 consecutive years were given a 2-page questionnaire inquiring about training protocols and local practice habits. Respondents included 64 vascular fellows from the academic year 1998-1999 (F98) and 52 vascular fellows from the academic year 1999-2000 (F99) (78% men in the entire population; mean age 34 years), representing a significant fraction of trainees in North America. Data from F98 and F99 were compared and analyzed. RESULTS: The majority (66%) of vascular surgery fellows were trained at university hospitals and performed EVS at the time of the survey: 83% in the F98 class and 92% in the F99 group (p=0.17). Utilization rates among the 9 interventions surveyed ranged from angiography (83%) and angioplasty (77%) to intravascular ultrasound (33%) and atherectomy (15%). Performance of endovascular grafting significantly increased among trainees (50% versus 81%, p<0.005), while atherectomy and angioscopy decreased. EVS performed in the operating room with portable imaging equipment decreased (67% versus 42%, p=0.02) as access to the radiology and cardiology suites increased. In most communities (63%), radiology specialists performed most of the EVS procedures, but the portion of communities where vascular surgery performed the majority of EVS procedures increased from 20% to 35% (p=0.10) from F98 to F99. Responders (90%) believed that EVS would become a major component of vascular surgery and comprise 30% of their future practice. The proportion of fellows who believed they were sufficiently trained in endovascular techniques increased from 30% to 50% (p=0.04), with the remainder willing to devote a short period (<3 months) for further training. CONCLUSIONS: The vast majority of vascular trainees perform EVS and believe that it will have an increasing role in their practice. Trends include increased endovascular grafting and performance of EVS by vascular surgeons in interventional suites.

Adult↗
PubMed2004

Hepatocyte growth factor and cardiovascular thrombosis in patients admitted to the intensive care unit.

BACKGROUND: Hepatocyte growth factor (HGF) has been reported as a marker of atherosclerosis and of thrombi synthesis, but the relationship between HGF and proven coronary thrombi has not been described. The aim of this study was to investigate this relationship in patients with chest pain. METHODS AND RESULTS: The study group comprised 107 patients with chest pain (61 acute myocardial infarction (AMI), 18 unstable angina, 15 stable angina, and 13 others; 65 males, 42 females; 66+/-11 years old). The presence of thrombi was evaluated by angiography, intravascular ultrasonography, angioscopy, and computed tomography. Serum HGF concentrations were measured using a new enzyme-linked immunosorbent assay. Serum HGF was significantly higher in the patients with AMI (335.0 +/-197.5 pg/ml), unstable angina (269.1+/-152.7 pg/ml), acute aortic dissection (320.3+/-116.5 pg/ml), and pulmonary thromboembolism (292.5+/-101.9 pg/ml), than in those with stable angina (171.2+/-56.1 pg/ml). Serum HGF concentration was also higher in those patients with proven thrombi than in those patients without (326.7+/-189.7 pg/ml vs 226.9+/-110.8 pg/ml). CONCLUSION: Increased serum HGF concentrations correlate with the presence of thrombi in patients with acute coronary syndrome, acute aortic dissection, and pulmonary thromboembolism.

Aged↗
PubMed1999

Fluorescence spectrum analysis of atherosclerotic plaque using doxycycline.

Using doxycycline (DOXY), fluorescence spectrum analysis was performed on arteriosclerotic lesions, and the efficacy of this method was examined in basic and clinical studies. In the basic study, DOXY 50 mg was administered intravenously to arteriosclerotic rabbits, and the thoracoabdominal aorta removed. Fluorescence spectral analysis was performed on each specimen, and the fluorescence spectral pattern, peak intensity and degree of intimal hypertrophy were studied. In the clinical study, DOXY 200 mg was administered intravenously to 6 human subjects with stable angina and coronary arterial stenosis of greater than 90%, and coronary angiography, coronary angioscopy and fluorescence spectral analysis were performed. DOXY accumulation in the arteriosclerotic intima of rabbit aortae was confirmed. The fluorescence spectrum was monomodal, peaking at around 532 nm. In the noncalcification group, significant correlation was observed between peak intensity and arteriosclerotic intimal thickness. Using DOXY as a fluorescent marker, it was possible to assess the level of arteriosclerotic intimal hypertrophy. Clinically, it was possible to obtain the DOXY spectrum of the coronary arteries.

Animals↗
PubMed1989

Recanalization of experimental thrombotic arterial occlusion by radiofrequency thermal angioplasty: an angioscopic observation.

The efficacy of radiofrequency (RF) angioplasty for recanalization of arterial thrombosis was assessed angioscopically in five dogs. A thrombus was induced by balloon injury of the left femoral artery. Within two hr, thrombi led to total occlusion of the artery in three dogs, subtotal occlusion in one, and about 70% obstruction in one. A metal-tipped catheter, with a tip size of 2.0 mm x 5.7 mm, was advanced into the thrombus and RF at 13.56 MHz was delivered repeatedly with gradually increased energies. The arterial lumina were recanalized or enlarged in all dogs. The thrombus surface had a shaggy appearance, and were dark (charring), or mixed dark and white in color. There were relatively large variations in the energies required; 140 J in one, 200 J in two and 250 J in two. The present results suggest that thrombotic arterial occlusion, such as acute occlusion complicating balloon angioplasty, can be treated with RF thermal angioplasty. Angioscopy provided detailed information about thrombus surfaces. The variations in required energies indicate the inability to control the thermal effect by energy settings alone. A more sophisticated method such as measurement of tip temperature will be able to overcome this difficulty.

Angioplasty, Balloon↗
PubMed1991

Vessel wall-related risk factors in acute vascular events.

Angiography in patients with unstable angina or myocardial infarction with subtotal coronary occlusion often reveals eccentric stenoses with irregular borders, suggesting ruptured atherosclerotic plaques and thrombosis, as documented by angioscopy and at autopsy. We have studied these processes in an ex vivo perfusion chamber, an in vivo swine model, and in human subjects. Our results, and those of other investigators, suggest that specific local risk factors at the time of plaque disruption influence the degree of thrombogenicity and, therefore, the various clinical syndromes. These risk factors can be divided into 2 groups: local vessel wall-related factors, and local (focal action) systemic factors. These risk factors include the following: 1) Rheological factors. It has been demonstrated that the more severe the stenotic lesion after plaque rupture, the higher the local shear rate with enhanced platelet deposition and thrombus formation; platelet deposition and thrombosis are particularly likely if the rupture includes the apex of the stenotic plaque, because of the high shear rate induced. 2) Degree of plaque damage. Plaque rupture produces a rough surface and stimulates an occlusive thrombus, which is enhanced depending on the degree of damage or amount of collagen type I and macrophage-dependent tissue factor exposed. 3) Residual thrombus. After spontaneous or pharmacological reperfusion, the surface of the residual thrombus is very thrombogenic and may contribute to reocclusion; this is partially due to thrombin bound to fibrin in the original thrombus. 4) Systemic factors. There is clinical and experimental evidence to suggest that 3 systemic factors at the time of plaque rupture may enhance thrombogenicity.(ABSTRACT TRUNCATED AT 250 WORDS)

Angina, Unstable↗
PubMed1992

The high-risk unstable angina patient. An approach to treatment.

Unstable angina, an intermediate stage in acute coronary ischaemic syndromes, accounts for about 50% of all admissions to the coronary care units in the United States today. It may progress to myocardial infarction in 15% of cases in the first 2 days, and the in-hospital mortality rate is 5%. The pathological hallmark of this syndrome, confirmed by angioscopy, is fissure of the atherosclerotic plaque within the coronary artery, leading to platelet adhesion and aggregation and fibrin-platelet thrombus formation, which may accelerate progression of the stenotic lesion. Management of unstable angina is aimed at ameliorating symptoms and reducing ischaemia, improving ventricular function, preventing recurrent ischaemia, myocardial infarction and death, and lastly, containing progression of the underlying coronary artery disease. Acute management includes bedrest, aspirin, heparin, nitroglycerin (glyceryl trinitrate) infusion and beta-blockers and calcium channel blockers in selected cases. After the patient is clinically stabilised, provocative tests and angiography may be performed, to be followed by angioplasty or bypass surgery, if necessary. In cases that are refractory to optimal medical therapy, interventions should be performed on a more emergent basis. Long term management includes aspirin and beta-blockers, if there is prior infarction, and control of the conventional risk factors.

Angina, Unstable↗
PubMed1999

[Ultrasonic imaging of coronary atherosclerosis].

Intra-coronary ultrasonography (ICV) is a technique for in vivo study of the different layers of the arterial wall, the site of atherosclerosis. A qualitative analysis of the composition of the plaque can predict its potential evolutivity (chronic with slow progression or at risk of rupture and causing acute thrombosis) and its response to different types of angioplasty, which could eventually become and essential factor in the choice of appropriate therapeutic strategy. Analysis of the results of B mode ultrasonic scanning has provided correlations with the histological composition of the arterial wall, validating the method and opening up the field of tissue characterisation which hitherto had been limited by the absence of sufficiently reliable, accurate and reproducible quantitative parameters. Magnetic resonance imaging (MRI) is a complementary, non-invasive tool for tissue analysis because its sensitivity to the biophysical and biochemical properties of tissues which makes it a promising method of morphological and functional imaging. Other methods of imaging atheromatous plaques include angioscopy and optic coherence tomography which have also contributed to the improvement in our knowledge of atherosclerosis. These methods of imaging which are slowly overcoming their limitations provide documents which ressemble more and more the histological appearances. Intracoronary ultrasonography is the most promising method and raises hopes that one day we shall be able to predict the outcome and anticipate the risk of rupture of atherosclerotic plaques.

Coronary Artery Disease↗