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Part of the book series: Developments in Cardiovascular Medicine ((DICM,volume 202))

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Abstract

The clinical illness of coronary artery disease is the end-stage of silent long established arterial disease or the rapid consecutive events following injury to the vessel wall. The most common form of degenerative arterial disease is atherosclerosis, which is a complex process determined by endothelial cell injury, migration, thrombosis and monocytes infiltration. These factors are related to the two main mechanisms of smooth muscle cell proliferation and lipid infiltration. Warning signs are present and timely action can reduce the risk both of a first attack and a recurrence. Cardiovascular medicine has improved the understanding of the clinical responsibility. This has involved a change in role perception and then a new technology, which is still evolving. Physicians are learning to move beyond the stage of treating the single risk factor which is readily accessible and measurable such as raised blood pressure to the concept of multiple interventions such as the implementation of systemic or local drug treatment and biomedical device delivery. There is still much scope for clinical scientists and practitioners to treat cardiovascular disease. Proper guidance by newly developed diagnostic methods and strategies will improve the therapeutic prospects of coronary artery disease.

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References

  1. Willard JE, Netto D, Demian SE, et al. Intravascular ultrasound Imaging of saphenous vein grafts in vitro: comparison with histologic and quantitative angiographic findings. J Am Coll Cardiol 1992; 19:759–64.

    Article  PubMed  CAS  Google Scholar 

  2. Rickenbacher PR, Pinto FJ, Chenzbraun A, et al. Incidence and severity of transplant coronary artery disease early and up to 15 years after transplantation as detected by intravascular ultrasound. J Am Coll Cardiol 1995; 25:171–7.

    Article  PubMed  CAS  Google Scholar 

  3. St Goar FG, Pinto FJ, Alderman EL, Fitzgerald PJ, Stadius ML, Popp RL. Intravascular ultrasound imaging of angiographically normal coronary arteries: an in vivo comparison with quantitative angiography. J Am Coll Cardiol 1991; 18:952–8.

    Article  PubMed  CAS  Google Scholar 

  4. Waller BF. Anatomy, histology, and pathology of the major epicardial coronary arteries relevant to echocardiographic imaging techniques. J Am Soc Echocardiogr 1989; 2:232–52.

    PubMed  CAS  Google Scholar 

  5. Mintz GS, Painter JA, Pichard AD, et al. Atherosclerosis in angiographically “normal” coronary artery reference segments: an intravascular ultrasound study with clinical correlations. J Am Coll Cardiol 1995; 25:1479–85.

    Article  PubMed  CAS  Google Scholar 

  6. Glagov S, Weisenberg E, Zarins CK, Stankunavicius R, Kolettis GJ. Compensatory enlargement of human atherosclerotic coronary arteries. N Engl JMed 1987; 316:1371–5.

    Article  CAS  Google Scholar 

  7. Honye J, Mahon DJ, Jain A, et al. Morphological effects of coronary balloon angioplasty in vivo assessed by intravascular ultrasound imaging. Circulation 1992; 85:1012–25.

    Article  PubMed  CAS  Google Scholar 

  8. Fitzgerald PJ, Yock PG. Mechanisms and outcomes of angioplasty and atherectomy assessed by intravascular ultrasound imaging. J Clin Ultrasound 1993; 21:579–88.

    Article  PubMed  CAS  Google Scholar 

  9. Fitzgerald PJ, Ports TA, Yock PG. Contribution of localized calcium deposits to dissection after angioplasty. An observational study using intravascular ultrasound. Circulation 1992; 86:64–70.

    Article  PubMed  CAS  Google Scholar 

  10. Mintz GS, Popma JJ, Pichard AD, et al. Intravascular ultrasound predictors of restenosis after percutaneous transcatheter coronary revascularization. J Am Coll Cardiol 1996; 27:1678–87.

    Article  PubMed  CAS  Google Scholar 

  11. Losordo DW, Rosenfield K, Pieczek A, Baker K, Harding M, Isner JM. How does angioplasty work? Serial analysis of human iliac arteries using intravascular ultrasound. Circulation 1992; 86:1845–58.

    Article  PubMed  CAS  Google Scholar 

  12. Mintz GS, Pichard AD, Kovach JA, et al. Impact of preintervention intravascular ultrasound imaging on transcatheter treatment strategies in coronary artery disease. Am J Cardiol 1994; 73:423–30.

    Article  PubMed  CAS  Google Scholar 

  13. Hodgson JM, Stone GW, St Goar FG, Linnemeier T, Sheehan H. Can intracoronary ultrasound improve PTCA results? Preliminary core lab ultrasound analysis from the CLOUT pilot study [abstract]. J Am Coll Cardiol 1995; 25(Special Issue):143A.

    Article  Google Scholar 

  14. Suarez de Lezo J, Romero M, Medina A, et al. Intracoronary ultrasound assessment of directional coronary atherectomy: immediate and follow-up findings. J Am Coll Cardiol 1993; 21:298–307.

    Article  PubMed  CAS  Google Scholar 

  15. Tenaglia AN, Buller CE, Kisslo KB, Stack RS, Davidson CJ. Mechanisms of balloon angioplasty and directional coronary atherectomy as assessed by intracoronary ultrasound. J Am Coll Cardiol 1992; 20:685–91.

    Article  PubMed  CAS  Google Scholar 

  16. Hinohara T, Rowe MH, Robertson GC, et al. Effect of lesion characteristics on outcome of directional coronary atherectomy. J Am Coll Cardiol 1991; 17:1112–20.

    Article  PubMed  CAS  Google Scholar 

  17. Mintz GS, Potkin BN, Keren G, et al. Intravascular ultrasound evaluation of the effect of rotational atherectomy in obstructive atherosclerotic coronary artery disease. Circulation 1992; 86:1383–93.

    Article  PubMed  CAS  Google Scholar 

  18. Nakamura S, Colombo A, Gaglione A, et al. Intracoronary ultrasound observations during stent implantation. Circulation 1994; 89(5):2026–34.

    Article  PubMed  CAS  Google Scholar 

  19. Goldberg SL, Colombo A, Nakamura S, Almagor Y, Maiello L, Tobis JM. Benefit of intracoronary ultrasound in the deployment of Palmaz-Schatz stents. J Am Coll Cardiol 1994; 24:996–1003.

    Article  PubMed  CAS  Google Scholar 

  20. Colombo A, Hall P, Nakamura S, et al. Intracoronary stenting without anticoagulation accomplished with intravascular ultrasound guidance. Circulation 1995; 91:1676–88.

    Article  PubMed  CAS  Google Scholar 

  21. Ambrose JA, Winters SL, Stern A, et al. Angiographic morphology and the pathogenesis of unstable angina pectoris. J Am Coll Cardiol 1985; 5:609–16.

    Article  PubMed  CAS  Google Scholar 

  22. Mizuno K, Miyamoto A, Isojima K, et al. A serial observation of coronary thrombi in vivo by a new percutaneous transluminal coronary angioscope. Angiology 1992; 43:91–9.

    Article  PubMed  CAS  Google Scholar 

  23. De Feyter PJ, Escaned J, Di Mario C, et al. Combined intracoronary ultrasound and angioscopic imaging in patients with unstable angina: target-lesion characteristics [abstract]. Eur Heart J 1993; 14:25 (Abstr Suppl):25

    Google Scholar 

  24. Den Heijer P, Foley DP, Hillege HL, et al. The “Ermenonville” classification of observations at coronary angioscopy — evaluation of intra-and inter-observer agreement. European Working Group on Coronary Angioscopy. Eur Heart J 1994; 15:815–22.

    Google Scholar 

  25. Thieme T, Wemecke KD, Meyer R, et al. Angioscopic evaluation of atherosclerotic plaques: validation by histomorphologic analysis and association with stable and unstable coronary syndromes. J Am Coll Cardiol 1996; 28:1–6.

    Article  PubMed  CAS  Google Scholar 

  26. Waxman S, Sassower MA, Mittleman MA, et al. Angioscopic predictors of early adverse outcome after coronary angioplasty in patients with unstable angina and non-Q-wave myocardial infarction. Circulation 1996; 93:2106–13.

    Article  PubMed  CAS  Google Scholar 

  27. Feld S, Ganim M, Carell ES, et al. Comparison of angioscopy, intravascular ultrasound imaging and quantitative coronary angiography in predicting clinical outcome after coronary intervention in high risk patients. J Am Coll Cardiol 1996; 28:97–105.

    Article  PubMed  CAS  Google Scholar 

  28. Alfonso F, Goicolea J, Hernandez R, et al. Findings of coronary angioscopy in angiographically normal coronary segments of patients with coronary artery disease. Am Heart J 1995; 130:987–93.

    Article  PubMed  CAS  Google Scholar 

  29. Knopf WD, Cates CU, Doby B, Langlois K. Coronary angioscopy influences intervention in patients with unstable angina and recent myocardial infarction. Circulation 1992; 86:(Suppl 1):I651.

    Google Scholar 

  30. Lablanche JM, Hamon M, McFadden EP, Bauters C, Quandalle P, Bertrand ME. Angiographically silent thrombus frequently persists after thrombolytic therapy for acute myocardial infarction: a prospective angioscopic study. Circulation 1993; 88(Suppl):1595.

    Google Scholar 

  31. Ueda Y, Asakura M, Hirayama A, Komamura K, Hori M, Komada K. Intracoronary morphology of culprit lesions after reperfusion in acute myocardial infarction: serial angioscopic observations. J Am Coll Cardiol 1996; 27:606-10.

    Google Scholar 

  32. Sassower MA, Abela GS, Koch JM, et al. Angioscopic evaluation of periprocedural and postprocedural abrupt closure after percutaneous coronary angioplasty. Am Heart J 1993; 126:444–50.

    Article  PubMed  CAS  Google Scholar 

  33. Jain A, Ramee SR, Mesa J, Collins TJ, White CJ. Intracoronary thrombus: chronic urokinase infusion and evaluation with intravascular ultrasound. Cathet Cardiovasc Diagn 1992; 26:212–4.

    Article  PubMed  CAS  Google Scholar 

  34. Den Heijer P, Van Dijk RB, Hillege HL, Pentinga ML, Serruys PW, Lie Kl. Serial angioscopic and angiographic observations during the first hour after successful coronary angioplasty: a preamble to a multicenter trial addressing angioscopic markers for restenosis. Am Heart J 1994; 128:656–63.

    Article  Google Scholar 

  35. Bauters C, Lablanche JM, McFadden EP, Hamon M, Bertrand ME. Relation of coronary angioscopic findings at coronary angioplasty to angiographic restenosis. Circulation 1995; 92:2473–9.

    Article  PubMed  CAS  Google Scholar 

  36. Teirstein PS, Schatz RA, Wong SC, Rocha-Singh KJ. Coronary stenting with angioscopic guidance. Am J Cardiol 1995; 75:344–7.

    Article  PubMed  CAS  Google Scholar 

  37. Strumpf RK, Heuser RR, Eagan JT Jr. Angioscopy: a valuable tool in the deployment and evaluation of intracoronary stents. Am Heart J 1993; 126:1204–10.

    Article  PubMed  CAS  Google Scholar 

  38. Resar JR, Brinker J. Early coronary artery stent restenosis: utility of percutaneous coronary angioscopy. Cathet Cardiovasc Diagn 1992; 27:276–9.

    Article  PubMed  CAS  Google Scholar 

  39. Herrmann HC, Buchbinder M, Clemen MW, et al. Emergent use of balloon-expandable coronary artery stenting for failed percutaneous transluminal coronary angioplasty. Circulation 1992; 86:812–9.

    Article  PubMed  CAS  Google Scholar 

  40. Schatz RA, Bairn DS, Leon M, et al. Clinical experience with the Palmaz-Schatz coronary stent. Initial results of a multicenter study. Circulation 1991; 83:148–61.

    Article  PubMed  CAS  Google Scholar 

  41. Den Heijer P, Van Dijk RB, Twisk SP, Lie Kl. Early stent occlusion is not always caused by thrombosis. Cathet Cardiovasc Diagn 1993; 29:136–40.

    Article  Google Scholar 

  42. Den Heijer P, Foley D, Escaned J, et al. Angioscopic versus angiographic detection of intimai dissection and intracoronary thrombus. J Am Coll Cardiol 1994; 24:649–54.

    Article  Google Scholar 

  43. Uretsky BF, Denys BG, Counihan PC, Ragosta M. Angioscopic evaluation of incompletely obstructing coronary intraluminal filling defects: comparison to angiography. Cathet Cardiovasc Diagn 1994; 33:323–9.

    Article  PubMed  CAS  Google Scholar 

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© 1998 Springer Science+Business Media New York

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den Heijer, P. (1998). Atherosclerosis Viewed from the Inside. In: Van Der Wall, E.E., Blanksma, P.K., Niemeyer, M.G., Vaalburg, W., Crijns, H.J.G.M. (eds) Advanced Imaging In Coronary Artery Disease. Developments in Cardiovascular Medicine, vol 202. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-0866-2_2

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  • DOI: https://doi.org/10.1007/978-94-007-0866-2_2

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-94-010-3746-4

  • Online ISBN: 978-94-007-0866-2

  • eBook Packages: Springer Book Archive

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