Assessment of ambiguous coronary lesions by intravascular ultrasound

Dietrich Baumgart (Corresponding Author), M. Haude, C. Von Birgelen, J. Ge, Günter Görge, R. Erbel

Research output: Contribution to journalReview articleAcademicpeer-review

3 Citations (Scopus)

Abstract

Until recently, coronary angiography has been regarded as the 'gold standard' for visualizing and quantifying coronary artery disease. Coronary angiography, however, is a luminographic technique revealing only the inner lumen of the coronary artery. In contrast, intravascular ultrasound investigations yield a detailed morphological description of the vessel wall and plaque characteristics. Based on these analyses, new insights into the pathogenesis of atherosclerotic coronary disease have evolved, including the remodeling phenomena. Thus, nowadays intravascular ultrasound can be regarded as the new 'gold standard' for the morphological assessment of lesion severity during cardiac catheterizations. Likewise, intracoronary Doppler and intracoronary pressure measurements have demonstrated their superiority in the functional assessment of coronary stenoses. Intravascular ultrasound investigations can be performed with high success and low complication rates. The present manuscript concentrates on the value of IVUS for the assessment of ambiguous lesions. Several forms of ambiguous lesions based on the angiographic appearance, i.e. intermediate lesion with undetermined stenosis severity, aneurysmatic widening of the coronary segment, ostial lesions, branching vessels, vessel tortuosity, main stem lesions, focal spasm, sites of plaque rupture, dissections, unclear haziness and contrast density changes are discussed and illustrated by respective angiographic and IVUS examples. Both the advantages and the limitations of angiographic and intravascular ultrasound examination are discussed in detail. In conclusion, additional intravascular ultrasound examination helps to diagnose accurately the underlying atherosclerotic disease, to define lesion characteristics and to optimize individual patient care and cost with respect to diagnostic catheterizations and coronary interventions.

Original languageEnglish
Pages (from-to)3-12
Number of pages10
JournalInternational journal of cardiovascular interventions
Volume2
Issue number1
DOIs
Publication statusPublished - 1 Jan 1999
Externally publishedYes

Keywords

  • Ambiguous coronary lesions
  • Atherosclerotic disease
  • Coronary angiography
  • IVUS

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