Intravenous ultrasound of the coronary arteries

[Guest guest]

Message: 19

Date: Thu, 20 Nov 2003 01:18:03 -0000

Rodney asked:

From: " Rodney " <perspect1111@...>

Subject: " Intravascular Untrasound "

I was just reading about a presentation at an AHA meeting in Orlando,

12th November 2003, where a Dr. Nissen of the Cleveland Clinic

was saying that: " The doctors used highly sensitive intravascular

ultrasound to watch what happened the the buildup, known as plaque,

in volunteers' heart arteries ............ " .

It sounds like something everyone ought to have done occasionally to

check the extent to which their arteries are, or are not, clogged.

Does anyone know if the procedure is available to real people

anywhere?

I am pretty sure my arteries are clean. But I would very much like

to know for certain one way or the other.

Rodney.

----------------

Rodney,

YES, this test is available to " real people anywhere. "

However,this is an invasive procedure. It involves threading an

ultrasound " camera " into the coronary artery, to get a cross

sectional view of the artery wall and the plaque.

It is a procedure done in conjunction with a coronary angiogram,

which involves threading a catheter from the groin to the coronary

circulation, squirting radio-opaque dye into the coronary

circulation, and then taking a " movie " of the coronary arteries.

Adding intravascular ultrasound to this procedure can sometimes

improve what is seen, and allows measurement of the % occlusion of

the coronary artery. Without the IVUS, one cannot measure the exact

% occlusion of the artery.

This invasive test has a death rate of 1:1000 to 1:10,000

Because it is invasive, a coronary angiogram/IVUS is only recommended

when other non-invasive tests discover a problem that needs to be

looked at more closely.

BTW, most coronary angiograms are performed without intravascular

ultrasound.

Non-invasive tests that can help assist in determining if one has

coronary artery disease include:

1. A physician examination (preferably a cardiologist).

2. A lipid profile lab test (total cholesterol, triglycerides, LDL

cholesterol (the bad cholesterol), HDL cholesterol (the good

cholesterol), VLDL cholesterol (also bad); other lab tests, such as C-

Reactive Protein, a test for inflammation; and a homocysteine test

(high homocysteine levels can be prevented with B12, folate and B6

supplementation); Lp(a) is also a good test to have, and possibly a

test for PAI-I (plasminogen activator inhibitor); PAI-I is also a

test for inflammation. Many consider the C-Reactive Protein to be

the single best blood test.

3. A treadmill MAXIMAL Stress Test (with 12-lead EKG monitoring)

4. A treadmill MAX Stress Test in conjunction with an echocardiogram

(echocardiogram detects normal and abnormal wall motion of the heart)

or a Thallium Scan (thallium scan determines blood " perfusion " of the

heart muscle to see if the perfusion is adequate.

5. PET scan of the heart is an excellent (but sometimes hard to

find) way to non-invasively look at the heart's blood perfusion).

6. A less expensive and less-good test is an " ultrafast CT scan of

the coronary arteries " , also called an " electron beam CT of the

coronary arteries. " You can get this for $300-400, but it tells you

more limited information (regarding the calcium present in your

coronary arteries).

Hope this helps,

rjb112@...

Bob Bessen

[Guest guest]

Hi Bob:

That is very a helpful and extraordinarily complete response. Thank

you. I had imagined that 'ultrasound' meant non-invasive.

I am not interested in invasive procedures that are probably

unnecessary.

Rodney.

> Message: 19

> Date: Thu, 20 Nov 2003 01:18:03 -0000

> Rodney asked:

>

> From: " Rodney " <perspect1111@y...>

> Subject: " Intravascular Untrasound "

>

> I was just reading about a presentation at an AHA meeting in

Orlando,

> 12th November 2003, where a Dr. Nissen of the Cleveland

Clinic

> was saying that: " The doctors used highly sensitive intravascular

> ultrasound to watch what happened the the buildup, known as plaque,

> in volunteers' heart arteries ............ " .

>

> It sounds like something everyone ought to have done occasionally

to

> check the extent to which their arteries are, or are not, clogged.

> Does anyone know if the procedure is available to real people

> anywhere?

>

> I am pretty sure my arteries are clean. But I would very much like

> to know for certain one way or the other.

>

> Rodney.

>

> ----------------

> Rodney,

>

> YES, this test is available to " real people anywhere. "

>

> However,this is an invasive procedure. It involves threading an

> ultrasound " camera " into the coronary artery, to get a cross

> sectional view of the artery wall and the plaque.

>

> It is a procedure done in conjunction with a coronary angiogram,

> which involves threading a catheter from the groin to the coronary

> circulation, squirting radio-opaque dye into the coronary

> circulation, and then taking a " movie " of the coronary arteries.

> Adding intravascular ultrasound to this procedure can sometimes

> improve what is seen, and allows measurement of the % occlusion of

> the coronary artery. Without the IVUS, one cannot measure the

exact

> % occlusion of the artery.

>

> This invasive test has a death rate of 1:1000 to 1:10,000

>

> Because it is invasive, a coronary angiogram/IVUS is only

recommended

> when other non-invasive tests discover a problem that needs to be

> looked at more closely.

>

> BTW, most coronary angiograms are performed without intravascular

> ultrasound.

>

> Non-invasive tests that can help assist in determining if one has

> coronary artery disease include:

>

> 1. A physician examination (preferably a cardiologist).

>

> 2. A lipid profile lab test (total cholesterol, triglycerides, LDL

> cholesterol (the bad cholesterol), HDL cholesterol (the good

> cholesterol), VLDL cholesterol (also bad); other lab tests, such as

C-

> Reactive Protein, a test for inflammation; and a homocysteine test

> (high homocysteine levels can be prevented with B12, folate and B6

> supplementation); Lp(a) is also a good test to have, and possibly a

> test for PAI-I (plasminogen activator inhibitor); PAI-I is also a

> test for inflammation. Many consider the C-Reactive Protein to be

> the single best blood test.

>

> 3. A treadmill MAXIMAL Stress Test (with 12-lead EKG monitoring)

>

> 4. A treadmill MAX Stress Test in conjunction with an

echocardiogram

> (echocardiogram detects normal and abnormal wall motion of the

heart)

> or a Thallium Scan (thallium scan determines blood " perfusion " of

the

> heart muscle to see if the perfusion is adequate.

>

> 5. PET scan of the heart is an excellent (but sometimes hard to

> find) way to non-invasively look at the heart's blood perfusion).

>

> 6. A less expensive and less-good test is an " ultrafast CT scan of

> the coronary arteries " , also called an " electron beam CT of the

> coronary arteries. " You can get this for $300-400, but it tells

you

> more limited information (regarding the calcium present in your

> coronary arteries).

>

> Hope this helps,

> rjb112@y...

> Bob Bessen