Angioscopic evaluation of atherosclerosis

: Recently, percutaneous transluminal angioscopy has been clinically used. We describe the evaluation of atherosclerosis by angioscopy. In observation of aortic and peripheral arteries, color of the luminal surface is yellow in the lesion without endothelial fibrosis, whereas, it is white with endothelial fibrosis. A variety of findings such as endothelial flap, endothelial thickening, mural bleeding, mural or occlusive thrombi are observed in the atherosclerotic lesions. It is difficult to detect these findings by angiography. In observation of coronary arteries, color of the luminal surface is yellow or white and often associates spiral folds in the early stage of atherosclerosis. Plaques are classified to two categories. One is the complex plaque characterised by endothelial flap, rupture of atheroma, ulceration, mural thrombus and usually observed in patients with unstable angina or myocardial infarction. Another is the regular plaque without those findings and observed in patients with stable angina. Angioscopy is useful for evaluation of atherosclerosis.