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1、Recent Progress in Coronary Imaging,Shunichi Miyazaki, MD, PhD Professor and Chairman, Division of Cardiology, Department of Internal Medicine Kinki University School of Medicine,Complex anatomy is difficult to understand in 3D manner.,Information regarding coronary plaque, per se, is essential.,Ang
2、iography shows 2D information as a silhouette,Atheromatous plaque,Coronary imaging should be oriented to obtain direct information of plaque.,Intra-Vascular UltraSound （IVUS） since early 90,Mechanical Scan,Linear Scan,Boston Scientific TERUMO,VOLCANO,Plaque Rupture,Lipid Core,Dissection,Lipid Core,D
3、issection,80 degree,Calcification,Calcification,Calcification,D IVUS,10mm,10mm,Distal,Stenosis,Proximal,8.7mm2,22.6mm2,16.4mm2,Ostium,Vascular Remodeling,Virtual Histology,Angioscopy since early 90,Angioscopy catheter,Vecmova (Clinical Supply) Catheter shaft 4.5Fr，balloon part 5.0Fr Pixels：3000 Visu
4、al angle：70 degree Depth：2mm,lens,Balloon,Normal endothelium,Yellow Plaque,White,Thin yellow,Yellow,Thick yellow,Thrombus, ： White thrombus ： few seconds after, white plaque increased along with red thrombus attachment C ： Mixed thrombus ： Red thrombus,AMI case,IVUS,Angioscopy,Plaque rupture,Angiosc
5、opy,IVUS,dissection,Lipid core,dissection,Mixed thrombus,64 yo, man, Anterior MI.,Non Q AMI case,IVUS,Angioscopy,Errosion,Angioscopy,IVUS,Mural thrombus,Yellow plaque,Calcification,Inferior AMI, 30 days after emergent PCI,Inferior AMI, 30 days after emergent PCI,Optical coherrence tomography (OCT),L
6、ight Lab OCTmonitorimage wireocclusion balloon,OCT equippment,Immediately after Cypher implantation,8 months after Cypher implant,周囲境界不明瞭， 内部均一高輝度領域,周囲境界明瞭, 内部 主不均一低輝度領域,周囲境界不明瞭，内 部主不均一低輝度領域,Lipid rich plaque,calcification,F,Fibrosis,C,F,OCT images,500m,500m,500m,OCT,CD68,250 m,B,A,OCT can detect ma
7、crophages,BMS 17M,BMS 7M,Intimal hyperplasia after Stenting,resolustion depth fibrosis lipid inflammation calc. thrombus IVUS 100m good Angioscopy N/A bad OCT 10m bad ,：sen sitivity90%，：8090%，：5080%，：50%,（MacNeill BD, Lowe HC, Takano M, Fuster V, Jang IK. Atherosclerosis Thromb Vasc Biol 2003;23:1333-1342.）,Summary,Thank you for your attention!,
