Three-dimensional palpography of human coronary arteries. Ex vivo validation and in-patient evaluation.
BACKGROUND
Rupture of thin-cap fibroatheroma is a major cause of acute myocardial infarction and stroke. Identification of these plaques is one of the major challenges in cardiovascular medicine. At present, techniques with sufficient sensitivity and specificity to identify these unstable plaques are not clinically available. This paper describes a new technique to identify these plaques.


RESULTS
Three-dimensional intravascular ultrasound palpography is a catheter-based technique that visualizes radial strain (deformation) of vascular tissue induced by physiological variations in intraluminal pressure. A three-dimensional palpogram of these cross sections can be constructed by performing a continuous pullback of the catheter. Phantom and animal experiments revealed feasibility and good reproducibility of three-dimensional palpography. Increased strain values were observed in areas with reduced cap thickness and increased macrophage accumulation. In patients (n = 2) three-dimensional palpography is feasible and identifies areas with high and low strain.


CONCLUSIONS
Three-dimensional palpography allows scanning of coronary arteries in patients to identify and localize highly deformable regions.
Erasmus University, Rotterdam, The Netherlands. j.schaar@erasmusmc.nl
Johannes A
JA
Schaar
Chris L
CL
de Korte
Frits
F
Mastik
Luc C A
LC
van Damme
Rob
R
Krams
Patrick W
PW
Serruys
Anton F W
AF
van der Steen
D000818:Animals; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D004548:Elasticity; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D010173:Palpation / Q000379:methods; D019047:Phantoms, Imaging; D011817:Rabbits; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018084:Ultrasonography, Interventional / Q000379:methods*