[Imaging in atherosclerosis: coronary arteriography].
Arteriography is still today the best imaging technique to evaluate coronary atherosclerosis. Some limitations have nonetheless been documented by pathologic studies (underestimated lesions), and by physiologic studies (poor correlation between stenosis and coronary flow reserve). Such limitations are due to the nature of the technique, as it provides the "silhouette" of the artery lumen, but does not provide any information on the artery wall, where the atherosclerotic plaque is located. Moreover, very often the vessel segment used as reference for stenosis calculation could also be affected by atherosclerosis; this occurrence plagues measurement of percent stenosis. On the other hand, a better usage of radiological techniques has also allowed a better assessment of certain stenosis shapes, such as eccentric or slit-like lesions. The introduction of quantitative coronary arteriography has overcome the problems related to visual assessment, such as the inter and intra observer variability. Furthermore, the recognized value of morphology analysis allows today a better characterization of the lesion. Coronary arteriography remains today a non-replaceable technique with regard to the choice of the most suitable revascularization procedures (coronary artery bypass graft, percutaneous transluminal coronary angioplasty) and supplies fundamental information for the interventional procedures.
Istituto di Cardiologia, Università degli Studi, Catania.
G
G
Russo
V
V
Calvi
C
C
Tamburino
A
A
Drago
G
G
Millan
A
A
Alì
C
C
Cinnirella
G
G
Giuffrida
D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans
Imaging nell'aterosclerosi: arteriografia coronarica.