The Value of Coronary Endoscopy in Patients with Stable and Unstable Angina Pectoris

Coronary angiography is the method of choice for documenting the extent and degree of coronary atherosclerotic lesions. Estimating lesion length and degree of stenosis (diameter and cross-section) provides qualitative and quantitative data for estimating the impairment of coronary flow distal to the stenotic coronary artery [2]. However, coronary angiography provides little information about the nature and surface of atherosclerotic plaques, and particularly about additional pathoanatomical processes at the site of the atheroma [1, 25, 27]. Some pathoanatomical postmortem studies have shown that in about 60%–70% of patients with myocardial infarctions thrombotic processes, fissures, and dissections of the atherosclerotic plaques may be present and may account for occlusion of a coronary vessel [3, 4, 6, 7]. Thus, it seems valuable from a clinical point of view to use endoscopic methods to visualize directly the atherosclerotic lesion for documenting such complications.