By Nicolaas Bom, Charles T. Lancée, Hans Rijsterborgh (auth.), J. Roelandt, E. J. Gussenhoven, N. Bom (eds.)

Intracoronary ultrasound is a swiftly evolving imaging modality and the expanding variety of released stories shows that the method is secure and offers incremental and extra exact diagnostic info than coronary angiography.
The method has the capability to check the pathobiology of atherosclerosis, to elucidate the importance of angiographically equivocal lesions and has helped us to appreciate the mechanisms, results and issues of catheter-based revascularization tactics. mixtures of imaging and healing units are being constructed for either tips and evaluate of the revascularization strategy. third-dimensional reconstruction of coronary segments is now attainable in actual time and offers the opertor with extra certain details on coronary pathology. during this monograph, top specialists within the box current the cutting-edge of a lot of these new developments.

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35 . Fitzgerald PI, Connolly AI , Watkins RD , et al. Distinction between soft plaque and thrombus by intravascular tissue characterization (Abstract) . J Am Coli CardioI1991;17:IIIA. 36. Landini L , Sarnelli R, Picano E, Salvadori M. Evaluation of frequency 21. 32 37. 38. P. G. Yock et al. dependence of backscatter coefficient in normal and atherosclerotic aortic waIls. Ultrasound Med BioI 1986;12:397-401. Barzilai B, Saffitz JE, MiIler JG, Sobel BE. Quantitative ultrasonic characterization of the nature of atherosclerotic plaque in human aorta .

Intravascular ultrasound shows the systolic compression of the artery with the elliptical deformation. Differentiation of coronary syndromes 39 Myocardial bridging Myocardial bridging has been reported in up to 5 % of the general population with increased detection rates using nitroglycerin and positive inotropic agents [47-49]. Ischemic syndromes such as angina pectoris, coronary spasm and myocardial infarction have been reported to be associated with this abnormality. Myocardial resection and bypass surgery were performed [50].

Yock et at. device is inserted and the housing is rotated the appropriate number of degrees relative to the origin of the diagonal branch (as seen now on the fluoroscope). Using this protocol our own, unpublished, experience is that subintimal sampling can be reduced to 10% or less while still performing aggressive cutting. The ability to selectively cut plaque could be greatly enhanced by direct imaging guidance mounted on the atherectomy catheter. Our group has developed a prototype combined imaging/atherectomy device in which an ultrasound transmitter is mounted immediately behind the cutting edge of a standard directional atherectomy device (Figure 3) [29] .

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