What Does the Yellow Color of Angioscopy Mean? Why Yellow Plaque Is Always Vulnerable?

Abstract

Angioscopy is the only imaging modality that can directly evaluate the color of plaques. Therefore, nothing is more important to angioscopy than color. Plaque is classified into yellow plaque and white plaque according to their color. Yellow plaque has been considered to be vulnerable and high risk for the acute coronary syndromes, especially high-intense yellow plaque. Beta carotene is lipotorophic binding to lipid and coexisting with lipids in human atherosclerotic lesions and produces the yellow color of atherosclerotic plaque. Yellow plaque has several kinds of histopathology, such as a thin fibrous cap with lipid core, superficial or diffuse lipid deposition (cholesterol and cholesterol ester) with or without macrophage-foam cells and calcified plate. Therefore, all yellow plaques might not be vulnerable. Some pharmacological intervention and trans-catheter therapy decreased the intensity of yellow color. As angioscopic interpretation of color is usually subjective, objective computerized colorimetric evaluation is desirable.