Coronary angiography as a luminogram provides a good overview of the coronary artery tree. By quantitative coronary measurements the degree of coronary obstruction can be determined. <BR> As a limitation coronary angiography does not provide information on the arterial wall structure and therefore cannot assess the extent of atherosclerosis. <BR> The knowledge about adaptive coronary remodeling processes as compensatory enlargement of the coronary artery has focused our diagnostic interest on the non-stenotic lesions of the coronary tree. Intravascular ultrasound (IVUS) could demonstrate the discrepancies between the extent of coronary atherosclerosis and angiography imaging by in-vivo plaque imaging. The spectrum analysis of IVUS-derived radio-frequency (RF) data enables a more detailed analysis of plaque composition and morphology.<BR> Preliminary in-vitro-studies correlated four histologic plaque components with a specific spectrum analysis of the RF data. The different components (fibrous, fibro-fatty, necrotic core and dense calcium) are colour-coded. The Coronary tissue maps are reconstructed from RF data using IVUS-Virtual HistologyTM software (Real-Time VH, Volcano Corporation, Rancho Cordova, CA). VH-IVUS has the potential to detect high risk lesions and can provide new insights into the pathophysiology of coronary artery disease. VH-IVUS allows the differentiation of different lesion types based on information derived from pathohistology. The in vivo specific histologic analysis of coronary atherosclerosis may allow a better stratification of treatment of patients with coronary artery disease.
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