[Endocoronary ultrasonography and angioplasty]

At the end of the 20th century, endocoronary ultrasonography has become established in many catheter laboratories. The information provided by this technique of invasive imaging has many qualitative and quantitative features. Is endocoronary ultrasonography a research or an everyday clinical tool to be used systematically or occasionally in routine procedures? Endocoronary ultrasonography is really a research tool because it is not redundant with conventional coronary angiography. Ultrasonography investigates the whole arterial wall. Its spatial resolution is twice that of angiography. Its contribution in this field in rich with many reports on arterial modelling, post-angioplasty remodelling, plaque rupture and atherothrombosis, the accurate description of the mechanical effects of angioplasty tools, two and three-dimensional quantification of atherosclerotic plaques and, finally, providing a very accurate biomechanical approach. Its use in routine procedures is only occasionally justified as there is no scientific proof in favour of a more widespread use with respect to changing the procedure or to evaluating patient prognosis. Endocoronary ultrasonography, a very rich technique, should be available in all catheter laboratories for occasional use. This technique is useful for all cardiologists performing coronary angioplasty by improving the evaluation of atheromatous plaques and countering the intrinsic ambiguities of coronary angioplasty.