ASSESSMENT OF INTRACORONARY MORPHOLOGY IN CARDIAC TRANSPLANT RECIPIENTS BY ANGIOSCOPY AND INTRAVASCULAR ULTRASOUND

Percutaneous coronary angioscopy and intravascular ultrasound are sens itive intravascular imaging methods for detecting early changes in cor onary morphology in cardiac transplant recipients. To compare the 2 im aging modalities, 29 consecutive cardiac transplant recipients underwe nt percutaneous coronary angioscopy and intravascular ultrasound durin g annual coronary angiography. Surface morphology, presence of plaque, and percent area stenosis were determined with each procedure. Percut aneous coronary angioscopy was more sensitive in detecting the presenc e of plaque and stenosis than was coronary angiography (plaque: 79 vs 10% [p < 0.001]; and stenosis: 24 vs 3% [p < 0.01]). Intravascular ult rasound was also more sensitive in detecting plaque (76 vs 10%; p < 0. 001) and stenosis (45 vs 3%; p < 0.001) than was coronary angiography. Although both angioscopy and ultrasound identified atherosclerotic pl aque, only percutaneous coronary angioscopy could show luminal surface morphology and pigmentation of the plaque. Conversely, ultrasound cou ld detect calcification and presence of intimal thickening, and was mo re accurate in assessing the severity of stenosis (45 vs 24%; p < 0.01 ). In conclusion, percutaneous coronary angioscopy and intravascular u ltrasound, in conjunction, provide information not only regarding the appearance of the luminal surface, but also quantitative information r egarding the structure and extent of the disease in the coronary arter y wall.