[Acute coronary syndrome diagnosed by the intravascular imaging]

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Diagnostic Imaging

Background:

• Coronary plaque rupture and subsequent thrombus formation are established causes of acute coronary syndrome (ACS).
• Pathological evidence for this mechanism dates back a century.
• Recent advancements in intravascular imaging have provided in vivo clinical validation.

Purpose of the Study:

• To highlight the role of intravascular imaging in diagnosing ACS lesions.
• To identify specific imaging characteristics indicative of ACS.
• To emphasize the importance of these findings in non-obstructive coronary artery disease.

Main Methods:

• Utilized intravascular ultrasound (IVUS) to detect ruptured fibrous caps.
• Employed coronary angioscopy to identify thrombus and yellow plaques.
• Correlated imaging findings with clinical evidence of ACS.

Main Results:

• IVUS identified ruptured fibrous caps as a key characteristic of ACS lesions.
• Coronary angioscopy revealed thrombus and yellow plaques in ACS patients.
• These characteristic findings were present even in lesions without significant stenosis.

Conclusions:

• Intravascular imaging modalities, specifically IVUS and coronary angioscopy, are crucial for diagnosing ACS.
• The presence of thrombus, yellow plaque, or a ruptured fibrous cap are definitive indicators of ACS lesions.
• Diagnosis of ACS lesions should rely on IVUS or coronary angioscopy, irrespective of the degree of stenosis.