In the early 1980s , when cardiac physicians were confronting how to tackle intra coronary thrombus , one man from Japan was looking directly at the ground zero with fiber-optic coronary angioscope .He provided live images of coronary plaques and thrombus (long before the IVUS and OCT era) because of technical difficulties it did not get into clinical utility but gave us vital information like plaque morphology and behavior.
- The concept of red and white thrombus
- The yellow lipid enriched vulnerable plaques
- Post lytic clot surface
- The fibrin strands within the clot etc.
The angioscopes have now given way to IVUS and OCT which provide indirect vision of the coronary arteries .Uchida has written a book tilted coronary angioscaopy which is a must read for all clinical cardiologists.
I think Japanese are leading in this aspect of cardiac Imaging .Yasunori Ueda is another person who has done lot of work on angioscopy . here is an Image from his paper. Exciting stuff is isn’t !