Lesions of Proximal Coronary Arteries

Abstract

Coronary artery disease (CAD) remains the leading cause of death in the Western world. Conventional coronary angiography (CCA) is the gold standard method for evaluation of the vascular lumen and provides excellent results in demonstrating stenotic lesions of CAD. However, it is an invasive procedure with a small risk of fatal events. Furthermore, CCA is a lumen-oriented technique that does not permit a direct visualization and evaluation of the coronary artery wall. The characterization of coronary plaques without a significant lumen narrowing is also not feasible with CCA. This information is relevant since the comparison of angiographic studies of coronary arteries performed before and after non-fatal myocardial infarction has shown that 49% of the pre-existing lesions before MI was <50% of stenosis (Fishbein and Siegel 1996). The detection of vulnerable atherosclerotic plaques within the wall of the coronary arteries could represent a key factor for the prevention of acute events (Naghavi et al. 2003).