How does the LipiScan catheter compare with angiography, intravascular ultrasound, optical coherence tomography and magnetic resonance imaging?
The techniques are very different, but complementary. Selective coronary angiography is the “gold standard” for detection of atherosclerosis and quantitation of the magnitude of obstructive disease. Unfortunately, angiography has intrinsic limitations. It provides a two-dimensional “lumenogram” that at best delineates the effects of plaque in the vessel wall that encroaches upon the lumen. While these images delineate the gross presence of disease and can quantify percent stenosis, angiography consistently underestimates the magnitude of atherosclerotic burden, particularly in earlier-stage disease, where positive vascular remodeling may allow “normal” lumen caliber despite substantial vascular wall plaque. Angiography is very accurate in the detection of complex, unstable plaques in patients with ACS. Unfortunately, angiography fails to detect the many plaques with subtler but pathologically manifest ulceration and rupture. It reflects only a subset of truly unstable coronary lesions
