Invasive imaging of coronary atherosclerotic plaques

Abstract

Coronary angiography depicts lumen narrowings caused by the encroachments of atherosclerotic plaques and thus provides a lumen cast of the coronary tree. A major limitation of angiography is its inability to study mild plaques that fail to reduce the coronary lumen, due to the Glagov phenomenon. Indeed, the vast majority of acute coronary syndromes (ACS) are due to acute thrombus formation at plaque sites that are not significant at angiography. On the other hand severe stenoses are less likely to cause major events.