Nezihi BARIŞ, İlke SİPAHİ, E. Murat TUZCU

Koroner aterosklerozun görüntülenmesinde intravasküler ultrasonografi beklentilerimizin ne kadarını karşılıyor

Koroner arter hastalığı akut koroner sendrom ve bunun yol açtığı hayatı tehdit eden komplikasyonlar nedeniyle hala önemini korumaktadır. Koroner aterosklerozun görüntülenmesinde sıklıkla kullanılan anjiyografi damar lümenini gösteren bir yöntemdir. Damar içi ultrasonografi lümenin yanı sıra damar duvarını ve aterosklerotik plağı da göstermektedir. IVUS’ un kullanıma girmesi ile lümen alanın hesaplanması, anjiyografik olarak darlık ciddiyetine karar verilemeyen plakların değerlendirilmesi, stent yerleştirilmesinde yeterli genişletmenin sağlanması konularında önemli gelişmeler sağlanmıştır. Kalp nakli hastalarında meydana gelen vaskülopatiyi anjiyografinin erken evrelerde tanıması güçtür. IVUS ile transplant vaskülopatisinin erken tanısı mümkün olmaktadır. Hassas plakların tespiti için IVUS sinyallerini daha ileri yöntemlerle değerlendirebilen radyofrekans analizi ve elastogram gelecekte önemi artacak yöntemlerdendir. Bunun yanı sıra ateroskleroz yaygınlığının tespiti ve koroner aterosklerozun hacimsel olarak hesaplanabilmesi IVUS’un bize sağladığı nicel verilerin başında gelir. Bu nicel veriler sayesinde koroner aterosklerozdaki ilerlemeler veya gerilemeler seri IVUS takipleriyle tespit edilebilir. Antiaterosklertoik ilaçların etkinliği de IVUS çalışmalarıyla bu sayede tespit edilmektedir.

Anahtar Kelimeler:

Tanı teknikleri, kalp damar, Ultrasonografi, girişimsel, Koroner arter hastalığı, Anjiyografi

What degree intravascular ultrasonography in coronary atherosclerosis meet our expectations

Coronary artery disease and acute coronary syndromes are a leading cause of mortality. Intravascular ultrasonography (IVUS) supplies more accurate information about plaque load and composition than coronary angiography. Especially, IVUS is a promising modality in the determination of vulnerable plaque. However, plaque burden and volumetric calculation of coronary atherosclerosis are determined by IVUS. Progression and/or regression of coronary atherosclerosis can be evaluated with these quantitative data. At the same time, the effects of potentially anti-atherosclerotic drugs on the coronary atherosclerosis can be measured with serial volumetric analysis.

Keywords:

Diagnostic Techniques, Cardiovascular, Ultrasonography, Interventional, Coronary Artery Disease, Angiography,

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