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Figure 1 Angiography shows a right coronary artery with three complex lesions containing ulcerations (A, B, and C); each has a corresponding intravascular ultrasound (IVUS) imaging run. In this figure and in Figure 2, each IVUS imaging run contains multiple image slices that are equidistantly spaced and that were selected to illustrate both the cross-sectional and longitudinal anatomy. The following consistent labeling will be used: double-headed white arrows outline the lipid core/crater with or without hemorrhage, arrow #1 indicates thrombus, arrow #2 indicates the actual rupture site, arrow #3 indicates the residual fibrous cap, and arrow #4 indicates calcium. In lesion A the slices are 0.5 mm apart, in lesion B the slices are 1.5 mm apart, and in lesion C the slices are 1.0 mm apart. Lesion A shows plaque disruption, probable thrombus, and a lipid core/crater; the actual site of rupture and the residual fibrous cap are not clearly evident. Lesion B shows all of the elements: lipid core/crater (double-headed arrow), site of rupture with residual fibrous cap (arrow #2), and thrombus (arrow #1). The rupture appeared to have occurred in the center of the fibrous cap. Lesion C shows a lipid core/crater (double-headed arrow), site of rupture, and residual fibrous cap (arrow #2), but no thrombus. The rupture appeared to have occurred at the shoulder of the fibrous cap.
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