Volumetric intravascular ultrasound quantification of the amount of atherosclerosis and calcium in nonstenotic arterial segments

Abstract

Cardiovascular morbidity and mortality have been traditionally linked to the number of coronary arteries with severe stenoses.1 However, more recent clinical findings have indicated that long-term patient outcome is highly dependent on the extent and severity of atherosclerosis.2 The extent of mild plaque (i.e., overall plaque burden) may be a stronger predictor of adverse coronary outcomes than the number of lesions or diseased arteries.3,4 Angiography has been the gold standard for assessing coronary atherosclerosis. However, angiography only displays the luminal contour; total plaque burden is grossly underestimated, especially in vessels that have undergone compensatory enlargement.5 The present study uses volumetric intravascular ultrasound (IVUS) to quantify the overall plaque burden in patients with de novo focal stenoses. We hypothesized that most of the plaque would be found outside of the focal stenoses. This hypothesis was tested by comparing the plaque volumes found within the length of the stenoses to the plaque volume of the adjacent nonstenotic segments.