Detection of silent arteriosclerotic lesions by intra-arterial ultrasonography

The aim of this study was to detect arteriosclerotic changes in the arterial wall at a preclinical stage. That is at a moment when these arteriosclerotic lesions are still fully asymptomatic and when the usual non-invasive vascular investigation techniques do not show any abnormalities.

Fifty-six patients with one or more critical stenoses of the coronary arteries, but with a completely normal peripheral vascular examination, were submitted to intravascular ultrasonography of the peripheral arterial system following coronary arteriography. Sonicath Ultrasound catheters were used and images were created with a Diasonics Imaging System.

Although these 56 patients, after a profound noninvasive investigation, were classified as having perfectly normal peripheral arteries, we found severe arteriosclerotic wall abnormalities of the abdominal aorta and/or the iliac arterial system in 5% of the subjects. In addition, this exploration technique was used to evaluate the nature and the structure of the registered degenerative arteriosclerotic lesions.

Intra-arterial ultrasonography obviously is a very sensitive investigation method which allows tracing arteriosclerotic changes of the arterial wall in a very early preclinical stage. The external ultrasound exploration techniques still have several important limitations, which, of course, do not hinder the intravascular application. The remaining disadvantage of the intra-arterial ultrasonography is however its invasive character.