INVASIVE STRATEGIES TO DISCRIMINATE STABLE AND UNSTABLE CORONARY PLAQUES

Unstable coronary plaques with surface erosion and plaque rupture lead to acute coronary thrombosis, unstable angina pectoris and myocardial infarction. The in-vivo detection of plaque instability by angiograph y, intravascular ultrasound or angioscopy or by newly developed techni ques, such as optical coherence tomography or by the observation of lo cal temperature increases, offers the opportunity for deeper understan ding of the mechanisms underlying plaque rupture and erosion. Pharmaco logical and transcatheter therapy might be directed more exclusively t o unstable plaques, once more detailed knowledge about pathophysiologi cal mechanisms as well as direct information about the individual plaq ue being treated is available.