3. Epiphany Thermography System
• A mono-rail system.
• One thermistor at the distal end
of 3-4 F catheter
• Accuracy 0.05o
C
• Almost wedging at the
atherosclerotic plaque
• Safe, fast procedure
• Wedging
• Full contact in significant
lesions
19. Identification of VulnerableIdentification of Vulnerable
PatientPatient
Coronary SinusCoronary Sinus
• In coronary sinus blood is drained mainly from the
left coronary artery
• An emerging technique is the measurement of the
trans-coronary gradient of various variables such as
cytokines, matrix metalloproteinases, etc..
• Measurement of blood temperature in coronary sinus
may provide significant iformation regarding the
inflammatory process within the myocardium
20. Atherosclerosis andAtherosclerosis and
Widespread InflammationWidespread Inflammation
• In this study the authors showed that
inflammation is widespread
• Even if lesions are found only in
RCA, the inflammatory markers
(activated leukocytes) are found also
in great cardiac vein
Buffon and Maseri, N Engl J Med 2002;
21. Th
Shaft
Coronary Sinus Thermography Catheter
A 7F thermography catheter
Proximal part: A steering arm
with a connector for the
thermistor lead-wires
Distal part: The distal 7 cm of
the shaft of the catheter consist
of a soft material.
A thermistor probe is
positioned at the tip of the
catheter.
Manipulation of the steering
arm proximally enables the
distal end of the catheter to be
C
31. 0
.05
.1
.15
.2
.25
ƒT ƒT-B
ΔT(o
C)
Baseline Balloon Inflation
Coronary Sinus and FlowCoronary Sinus and Flow
Temperature difference (ΔΤ) in control subjects at baseline
and during interruption of coronary flow.
32. Conclusions
•Today’s challenge is to identify and treat the vulnerable
plaques.
•Thermography is a new promising method for the early
detection of vulnerable plaques.
• Aggressive lipid therapy, antiplatelet agents and
medications have favorable results in thermal heterogeneity.
•Clinical studies are required to investigate whether there is
clinical benefit from lowering thermal heterogeneity locally
at the culprit or non-culprit lesions.