Intravascular ultrasound of patient 14 years after transplant

Intravascular ultrasound (IVUS) image taken during evaluation of a 19-year-old patient 14 years after transplant. Virtual Histology (Volcano Corporation) technology shows scattered abnormal tissue densities surrounding the vessel lumen, including fibrous and calcific changes (arrow, right side of image) and intimal thickening (arrow, left side of image), suggesting the presence of graft vasculopathy. This patient had a normal coronary angiogram, and graft vasculopathy would not have been diagnosed without the use of IVUS.