Stenting will suddenly become a more viable option for many patients now being referred for bypass surgery, for instance. Drug-eluting stents are already a reality. The technology has all but been solved, and what remains is for the technology to be refined, and to be made inexpensive enough to allow hospitals to purchase the equipment in sufficient quantities. But within a few years, it now finally appears as if diagnosing coronary artery disease will move into the realm of noninvasive cardiology. Identifying vulnerable plaques Not all coronary artery lesions are equal.
Some atherosclerotic plaques are relatively stable, and relatively unlikely to cause heart attacks.
Other plaques are particularly vulnerable to rupture, which triggers the clotting phenomenon that produces sudden blockage of the coronary artery and thus heart attacks. Unfortunately, when a partial blockage is viewed on a standard heart catheterization, there is no way to distinguish between stable and vulnerable plaques. Therapy, therefore, is directed toward the degree of blockage, and not whether a plaque is actually more prone to rupture. MRI techniques are now being actively developed to help distinguish between stable and vulnerable plaques. Angiogenesis Angiogenesis is the growth of new blood vessels.