Spontaneous Ruptured Aortic Plaques and Injuries Detected using Non-obstructive General Angioscopy

Spatial and temporal resolution of NOGA are superior to CTA and transesophageal echocardiography. NOGA provides direct images of both intimal and subintimal images. Aortic angioscopy using non-obstructive general angioscopy (NOGA) is a novel, video-based technique that allows visualization of the inner aorta. Dual infusion method improves the visual field and the use of an Ikari-L guiding catheter allows easy access to the aorta, enabling NOGA of not only the coronary artery but also aorta. Imaging techniques such as computed tomography angiography (CTA), magnetic resonance, and transesophageal echocardiography have been used to evaluate the aorta and the findings are usually confirmed based on pathology. NOGA has a spatial and temporal resolution superior to these techniques, detecting various types of spontaneous ruptured aortic plaques (SRAPs) and injuries. SRAPs detected using NOGA are not comparable to those detected using CTA. NOGA can also demonstrate subintimal changes and blood flow through the aortic wall. Although aortic angioscopy is yet at its dawn, several case reports have showed its ability to decode aortic dissection pathogenesis and to evaluate the merits and demerits of stent graft implantation. NOGA is a unique invasive modality to visualize the inner aorta and to sample SRAPs. NOGA is an epoch-making modality that can be used to simultaneously evaluate the arterial and venous systems.