The postmortem detection of coronary artery lesions using coronary arteriography.
Postmortem coronary angiography was undertaken in 230 hospital deaths from all causes. X-rays before and after decalcification of the intact coronary arterial tree were assessed with regard to the degree and morphology of arterial lesions and extent of calcification. These angiographic appearances were correlated with histological sections following routine paraffin embedding and serial sectioning where appropriate. Stable but patent lesions, characterized histologically by an intact plaque cap and no intraluminal thrombus formation, angiographically revealed a smooth interface between the barium and vessel wall with no filling defect and often an hour-glass configuration. In contrast, patent unstable lesions, characterized histologically by plaque fissuring and intra-intimal or intraluminal thrombus formation, showed an irregular interface angiographically, often with irregular filling defects. Similarly, distinction between an old stable occlusion and a recent thrombotic occlusion could be made angiographically on the basis of smooth or irregular interfaces between barium and vessel wall. Various angiographic appearances are interpreted in the light of the histological morphology encountered and it is concluded that postmortem coronary angiography is an accurate, rapid and invaluable technique in the autopsy investigation of ischemic heart disease and sudden death.
Thomas
A C
AC
Institute of Medical and Veterinary Science, Adelaide.
Pazios
S
S
D000792:Angiography / Q000379:methods; D001344:Autopsy; D001464:Barium; D003327:Coronary Disease / Q000175:diagnosis* / Q000473:pathology; D003328:Coronary Thrombosis / Q000175:diagnosis / Q000473:pathology; D003331:Coronary Vessels / Q000473:pathology; D006801:Humans
D001464:Barium