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Adventitia measurement in coronary artery: an in vivo intravascular ultrasound study
  1. G Rioufol1,*,
  2. M Elbaz1,
  3. O Dubreuil1,
  4. A Tabib2,
  5. G Finet1,*
  1. 1Department of Hemodynamics and Interventional Cardiology, Cardiovascular Hospital, Hospices Civils de Lyon and Claude Bernard University, Lyons, France
  2. 2Department of Pathology, Cardiovascular Hospital, Hospices Civils de Lyon and Claude Bernard University, Lyons, France
  1. Correspondence to:
    Dr Gilles Rioufol
    Department of Hemodynamics, Cardiovascular Hospital, B P Lyon-Monchat, 69394 Lyons Cedex 03, France; gilles.rioufol{at}univ-lyon1.fr

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Recent studies have highlighted the dynamic role of the adventitia in the genesis of atherosclerosis,1 atherothrombotic events2 and restenosis after balloon angioplasty.3

Intravascular ultrasound (IVUS) provides a unique means of studying atherosclerosis in vivo, but the lack of any acoustic interface behind the adventitia notoriously prevents analysis of the adventitia. Careful analysis of IVUS images, however, often finds slight pericardial detachments just to the rear of the artery being explored. This situation creates a new anechogenic acoustic medium at the external edge of the adventitia, setting up a new acoustic interface, thus clearly identifying the adventitial tunica (fig 1).

Figure 1

 (A) Typical example of visualisation of adventitia during in vivo intravascular ultrasound (IVUS) examination in the left anterior descending artery. (B) Bland–Altman plot comparing adventitial thickness with histological results and IVUS. *IVUS probe.

We first conducted an ex vivo study to test this hypothesis and validate the precision of the adventitia measurements. The relevance of such data in humans in vivo was then assessed by IVUS studies of the left anterior descending …

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