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 REVIEW ARTICLE
Year : 2003  |  Volume : 49  |  Issue : 4  |  Page : 361-368

Vulnerable Plaques, Inflammation and Newer Imaging Modalities


1 Department of Internal Medicine, SUNY, Buffalo, NY, USA
2 Department of Molecular Biology, University of Houston, Texas, USA

Correspondence Address:
V Bhatia
Mercy Hospital of Buffalo, 565, Abbott Road, Buffalo, NY, 14220,
USA
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Source of Support: None, Conflict of Interest: None


PMID: 14699240

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Currently, inflammation is considered to be the central player in the pathogenesis of atherosclerosis. It leads to the formation of multiple plaques in the arterial beds including coronary vasculature. Recent studies using the latest imaging techniques have shown that in patients with acute coronary syndromes (ACS) multiple plaques are ruptured and have thrombus formation on them. Various factors make these plaques unstable, these include structural components of plaque like thin fibrous cap, high lipid content of the plaque core and inflammation, both localized and generalized. It has been shown that most of the ACS are caused by plaques causing non-critical stenosis as seen on traditional X-ray angiography. Also, the phenomenon of remodelling makes angiography a poor technique for plaque visualization. Hence newer modalities are required to identify these “vulnerable plaques”. Intravascular ultrasound (IVUS), thermography and Magnetic Resonance Imaging (MRI) are a few such promising techniques. Here we review the invasive and non-invasive modalities that can be helpful in the identification of these plaques before they become unstable and cause ACS, and also the available therapies to stabilize these plaques.






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Online since 12th February '04
© 2004 - Journal of Postgraduate Medicine
Official Publication of the Staff Society of the Seth GS Medical College and KEM Hospital, Mumbai, India
Published by Wolters Kluwer - Medknow