IS ACOUSTIC SHADOWING AT INTRACORONARY ULTRASOUND ALWAYS THE MARKER OF INTRAMURAL CALCIUM ACCUMULATION

Intracoronary ultrasound (ICUs) is increasingly used at catheterizatio n to assess more precisely the severity of luminal narrowing, to delin eate the composition of the atherosclerotic plaque, and to select the optimal therapeutic strategy. With this technique, a drop in signal in tensity, known as acoustic shadowing, is usually equated with the pres ence of calcium in the plaque. We report the study of an atherosclerot ic coronary artery showing intense acoustic shadowing at ICUS, but in which no calcium deposition could be evidenced at postmortem pathologi cal analysis. This observation suggests a word of caution with regard to considering acoustic shadowing at ICUs as the reflection of superfi cial calcium deposition within a vessel wall. (C) 1995 Wiley-Liss, Inc .