Endocoronary ultrasonography and angioplasty.

At the end of the 20th century, endocoronary ultrasonography has become est ablished in many catheter laboratories. The information provided by this te chnique of invasive imaging has many qualitative and quantitative features. Is endocoronary ultrasonography a research or an everyday clinical tool to be used systematically or occasionally in routine procedures? Endocoronary ultrasonography is really a research tool because it is not re dundant with conventional coronary angiography. Ultrasonography investigate s the whole arterial wall. Its spatial resolution is twice that of angiogra phy Its contribution in this field is rich with many reports on arterial mo delling, post-angioplasty remodelling, plaque rupture and atherothrombosis, the accurate description of the mechanical effects of angioplasty tools, t wo and three-dimensional quantification of atherosclerotic plaques and, fin ally, providing a very accurate biomechanical approach. Its use in routine procedures is only occasionally justified as there is no scientific proof in favour of a more widespread use with respect to changi ng. the procedure or to evaluating patient prognosis. Endocoronary ultrasonography, a very rich technique, should be available in all catheter laboratories for occasional use. This technique is useful for all cardiologists performing coronary angiopla sty by improving the evaluation of atheromatous plaques and countering the intrinsic ambiguities of coronary angioplasty.