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Circulation. 1991;83:913-926

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Circulation, Vol 83, 913-926, Copyright © 1991 by American Heart Association


ARTICLES

Intravascular ultrasound imaging of human coronary arteries in vivo. Analysis of tissue characterizations with comparison to in vitro histological specimens

JM Tobis, J Mallery, D Mahon, K Lehmann, P Zalesky, J Griffith, J Gessert, M Moriuchi, M McRae and ML Dwyer
Department of Pathology, University of California, Irvine Medical Center, Orange 92613-4091.

BACKGROUND. Intravascular ultrasound imaging was performed in 27 patients after coronary balloon angioplasty to quantify the lumen and atheroma cross-sectional areas. METHODS AND RESULTS. A 20-MHz ultrasound catheter was inserted through a 1.6-mm plastic introducer sheath across the dilated area to obtain real-time images at 30 times/sec. The ultrasound images distinguished the lumen from atheroma, calcification, and the muscular media. The presence of dissection between the media and the atheroma was well visualized. These observations of tissue characterization were compared with an in vitro study of 20 human atherosclerotic artery segments that correlated the ultrasound images to histological preparations. The results indicate that high-quality intravascular ultrasound images under controlled in vitro conditions can provide accurate microanatomic information about the histological characteristics of atherosclerotic plaques. Similar quality cross-sectional ultrasound images were also obtained in human coronary arteries in vivo. Quantitative analysis of the ultrasound images from the clinical studies revealed that the mean cross-sectional lumen area after balloon angioplasty was 5.0 +/- 2.0 mm2. The mean residual atheroma area at the level of the prior dilatation was 8.7 +/- 3.4 mm2, which corresponded to 63% of the available arterial cross- sectional area. At the segments of the coronary artery that appeared angiographically normal, the ultrasound images demonstrated the presence of atheroma involving 4.7 +/- 3.2 mm2, which was a mean of 35 +/- 23% of the available area bounded by the media. CONCLUSIONS. Intravascular ultrasound appears to be more sensitive than angiography for demonstrating the presence and extent of atherosclerosis and arterial calcification. Intracoronary imaging after balloon angioplasty reveals that a significant amount of atheroma is still present, which may partly explain why the incidence of restenosis is high after percutaneous transluminal coronary angioplasty.


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Treatment of In-Stent Restenosis With Excimer Laser Coronary Angioplasty : Mechanisms and Results Compared With PTCA Alone
Circulation, October 7, 1997; 96(7): 2183 - 2189.
[Abstract] [Full Text]


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Arterioscler. Thromb. Vasc. Bio.Home page
M. K. Hong, J. Vossoughi, G. S. Mintz, R. D. Kauffman, R. F. Hoyt Jr, J. F. Cornhill, E. E. Herderick, M. B. Leon, and J. M. Hoeg
Altered Compliance and Residual Strain Precede Angiographically Detectable Early Atherosclerosis in Low-Density Lipoprotein Receptor Deficiency
Arterioscler. Thromb. Vasc. Biol., October 1, 1997; 17(10): 2209 - 2217.
[Abstract] [Full Text]


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CirculationHome page
H. Berglund, H. Luo, T. Nishioka, M. C. Fishbein, N. L. Eigler, S. W. Tabak, and R. J. Siegel
Highly Localized Arterial Remodeling in Patients With Coronary Atherosclerosis : An Intravascular Ultrasound Study
Circulation, September 2, 1997; 96(5): 1470 - 1476.
[Abstract] [Full Text]


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CirculationHome page
Y. Ozaki, A. G. Violaris, T. Kobayashi, D. Keane, E. Camenzind, C. Di Mario, P. de Feyter, J. R. T. C. Roelandt, and P. W. Serruys
Comparison of Coronary Luminal Quantification Obtained From Intracoronary Ultrasound and Both Geometric and Videodensitometric Quantitative Angiography Before and After Balloon Angioplasty and Directional Atherectomy
Circulation, July 15, 1997; 96(2): 491 - 499.
[Abstract] [Full Text]


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CirculationHome page
I. Moussa, C. Di Mario, J. Moses, B. Reimers, L. Di Francesco, G. Martini, J. Tobis, and A. Colombo
Coronary Stenting After Rotational Atherectomy in Calcified and Complex Lesions : Angiographic and Clinical Follow-Up Results
Circulation, July 1, 1997; 96(1): 128 - 136.
[Abstract] [Full Text]


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CirculationHome page
R. J.G. Peters, W. E.M. Kok, C. Di Mario, P. W. Serruys, F. W.H.M. Bar, G. Pasterkamp, C. Borst, O. Kamp, J. G.F. Bronzwaer, C. A. Visser, et al.
Prediction of Restenosis After Coronary Balloon Angioplasty: Results of PICTURE (Post–IntraCoronary Treatment Ultrasound Result Evaluation), a Prospective Multicenter Intracoronary Ultrasound Imaging Study
Circulation, May 6, 1997; 95(9): 2254 - 2261.
[Abstract] [Full Text]


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CirculationHome page
G. S. Mintz, K. M. Kent, A. D. Pichard, L. F. Satler, J. J. Popma, and M. B. Leon
Contribution of Inadequate Arterial Remodeling to the Development of Focal Coronary Artery Stenoses : An Intravascular Ultrasound Study
Circulation, April 1, 1997; 95(7): 1791 - 1798.
[Abstract] [Full Text]


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CirculationHome page
R. Albiero, P. Hall, A. Itoh, S. Blengino, S. Nakamura, G. Martini, M. Ferraro, and A. Colombo
Results of a Consecutive Series of Patients Receiving Only Antiplatelet Therapy After Optimized Stent Implantation: Comparison of Aspirin Alone Versus Combined Ticlopidine and Aspirin Therapy
Circulation, March 4, 1997; 95(5): 1145 - 1156.
[Abstract] [Full Text]


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CirculationHome page
H. Berglund, H. Luo, T. Nishioka, N. L. Eigler, C.-J. Kim, S. W. Tabak, and R. J. Siegel
Preserved Vasodilatory Response to Nitroglycerin in Saphenous Vein Bypass Grafts
Circulation, December 1, 1996; 94(11): 2871 - 2876.
[Abstract] [Full Text]


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CirculationHome page
R. Hoffmann, G. S. Mintz, G. R. Dussaillant, J. J. Popma, A. D. Pichard, L. F. Satler, K. M. Kent, J. Griffin, and M. B. Leon
Patterns and Mechanisms of In-Stent Restenosis: A Serial Intravascular Ultrasound Study
Circulation, September 15, 1996; 94(6): 1247 - 1254.
[Abstract] [Full Text]


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CirculationHome page
J. Escaned, J. Baptista, C. Di Mario, J. Haase, Y. Ozaki, D. T. Linker, P. J. de Feyter, J. R.T.C. Roelandt, and P. W. Serruys
Significance of Automated Stenosis Detection During Quantitative Angiography: Insights Gained From Intracoronary Ultrasound Imaging
Circulation, September 1, 1996; 94(5): 966 - 972.
[Abstract] [Full Text]


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CirculationHome page
L. Wexler, B. Brundage, J. Crouse, R. Detrano, V. Fuster, J. Maddahi, J. Rumberger, W. Stanford, R. White, and K. Taubert
Coronary Artery Calcification: Pathophysiology, Epidemiology, Imaging Methods, and Clinical Implications: A Statement for Health Professionals From the American Heart Association
Circulation, September 1, 1996; 94(5): 1175 - 1192.
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ANGIOLOGYHome page
Y. Nakamura, H. Takemori, K. Shiraishi, I. Inoki, M. Sakagami, A. Shimakura, K. Usuda, K. Kubota, S. Takata, and K.-i. Kobayashi
Compensatory Enlargement of Angiographically Normal Coronary Segments in Patients with Coronary Artery Disease: In Vivo Documentation Using Intravascular Ultrasound
Angiology, August 1, 1996; 47(8): 775 - 781.
[Abstract] [PDF]


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G. S. Mintz, J. J. Popma, A. D. Pichard, K. M. Kent, L. F. Satler, Y. Chien Chuang, R. A. DeFalco, and M. B. Leon
Limitations of Angiography in the Assessment of Plaque Distribution in Coronary Artery Disease : A Systematic Study of Target Lesion Eccentricity in 1446 Lesions
Circulation, March 1, 1996; 93(5): 924 - 931.
[Abstract] [Full Text]


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CirculationHome page
J. L. Evans, K.-H. Ng, S. G. Wiet, M. J. Vonesh, W. B. Burns, M. G. Radvany, B. J. Kane, C. J. Davidson, S. I. Roth, B. L. Kramer, et al.
Accurate Three-Dimensional Reconstruction of Intravascular Ultrasound Data : Spatially Correct Three-Dimensional Reconstructions
Circulation, February 1, 1996; 93(3): 567 - 576.
[Abstract] [Full Text]


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CirculationHome page
G. S. Mintz, J. A. Kovach, S. P. Javier, A. D. Pichard, K. M. Kent, J. J. Popma, L. F. Salter, and M. B. Leon
Mechanisms of Lumen Enlargement After Excimer Laser Coronary Angioplasty : An Intravascular Ultrasound Study
Circulation, December 15, 1995; 92(12): 3408 - 3414.
[Abstract] [Full Text]


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CirculationHome page
Y. Ozaki, D. Keane, and P. W. Serruys
Progression and Regression of Coronary Stenosis in the Long-term Follow-up of Vasospastic Angina
Circulation, November 1, 1995; 92(9): 2446 - 2456.
[Abstract] [Full Text]


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CirculationHome page
V. Schachinger and A. M. Zeiher
Quantitative Assessment of Coronary Vasoreactivity in Humans In Vivo : Importance of Baseline Vasomotor Tone in Atherosclerosis
Circulation, October 15, 1995; 92(8): 2087 - 2094.
[Abstract] [Full Text]


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CirculationHome page
E. J. Topol and S. E. Nissen
Our Preoccupation With Coronary Luminology : The Dissociation Between Clinical and Angiographic Findings in Ischemic Heart Disease
Circulation, October 15, 1995; 92(8): 2333 - 2342.
[Abstract] [Full Text]


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CirculationHome page
P. J. de Feyter, Y. Ozaki, J. Baptista, J. Escaned, C. Di Mario, P. P.T. de Jaegere, P. W. Serruys, and J. R.T.C. Roelandt
Ischemia-Related Lesion Characteristics in Patients With Stable or Unstable Angina : A Study With Intracoronary Angioscopy and Ultrasound
Circulation, September 15, 1995; 92(6): 1408 - 1413.
[Abstract] [Full Text]


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Arterioscler. Thromb. Vasc. Bio.Home page
H. C. Stary, A. B. Chandler, R. E. Dinsmore, V. Fuster, S. Glagov, W. Insull Jr, M. E. Rosenfeld, C. J. Schwartz, W. D. Wagner, and R. W. Wissler
A Definition of Advanced Types of Atherosclerotic Lesions and a Histological Classification of Atherosclerosis : A Report From the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association
Arterioscler. Thromb. Vasc. Biol., September 1, 1995; 15(9): 1512 - 1531.
[Abstract] [Full Text]


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CirculationHome page
H. C. Stary, A. B. Chandler, R. E. Dinsmore, V. Fuster, S. Glagov, W. Insull Jr, M. E. Rosenfeld, C. J. Schwartz, W. D. Wagner, and R. W. Wissler
A Definition of Advanced Types of Atherosclerotic Lesions and a Histological Classification of Atherosclerosis : A Report From the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association
Circulation, September 1, 1995; 92(5): 1355 - 1374.
[Abstract] [Full Text]


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CirculationHome page
G. S. Mintz, J. J. Popma, A. D. Pichard, K. M. Kent, L. F. Satler, Y. C. Chuang, C. J. Ditrano, and M. B. Leon
Patterns of Calcification in Coronary Artery Disease : A Statistical Analysis of Intravascular Ultrasound and Coronary Angiography in 1155 Lesions
Circulation, April 1, 1995; 91(7): 1959 - 1965.
[Abstract] [Full Text]


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CirculationHome page
A. Colombo, P. Hall, S. Nakamura, Y. Almagor, L. Maiello, G. Martini, A. Gaglione, S. L. Goldberg, and J. M. Tobis
Intracoronary Stenting Without Anticoagulation Accomplished With Intravascular Ultrasound Guidance
Circulation, March 15, 1995; 91(6): 1676 - 1688.
[Abstract] [Full Text]


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CirculationHome page
D. Hausmann, R. Erbel, M.-J. Alibelli-Chemarin, W. Boksch, E. Caracciolo, J. M. Cohn, S. C. Culp, W. G. Daniel, I. De Scheerder, C. DiMario, et al.
The Safety of Intracoronary Ultrasound : A Multicenter Survey of 2207 Examinations
Circulation, February 1, 1995; 91(3): 623 - 630.
[Abstract] [Full Text]


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ANGIOLOGYHome page
S. H. Duda, M. Wehrmann, B. Erdtmann, P. E. Huppert, and C. D. Claussen
Intravascular Ultrasound: Value of Electronic and Mechanical Devices for Quantifying Mild to Moderate Atherosclerosis
Angiology, July 1, 1994; 45(7): 597 - 603.
[Abstract] [PDF]


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ANN INTERN MEDHome page
R. L. Minor Jr., B. D. Scott, D. D. Brown, and M. D. Winniford
Cocaine-induced Myocardial Infarction in Patients with Normal Coronary Arteries
Ann Intern Med, November 15, 1991; 115(10): 797 - 806.
[Abstract] [PDF]


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CirculationHome page
A. Tanaka, T. Kawarabayashi, Y. Nishibori, T. Sano, Y. Nishida, D. Fukuda, K. Shimada, and J. Yoshikawa
No-Reflow Phenomenon and Lesion Morphology in Patients With Acute Myocardial Infarction
Circulation, May 7, 2002; 105(18): 2148 - 2152.
[Abstract] [Full Text] [PDF]