Objective-In large-and medium-sized arteries, the diffusion distances for oxygen and nutrients are long. This has been suggested to make these vessels prone to develop local energy metabolic deficiencies that could contribute to atherogenesis. To validate this hypothesis, we introduced a new method to measure energy metabolites within the arterial wall at high spatial resolution. Methods and Results-Bioluminescence imaging was used to quantify local metabolite concentrations in cryosections of snap frozen (in vivo) and incubated pig carotid artery rings. Incubation at hypoxia resulted in increased lactate concentrations, whereas ATP, glucose, and glycogen concentrations were decreased, especially in the mid media, where concentrations of these metabolites were close to zero. In snap frozen arteries, glycogen concentrations were markedly higher in deep layers of the media than toward the lumen. ATP, glucose, and lactate were more homogenously distributed. Key Words: atherosclerosis Ⅲ hypoxia Ⅲ bioluminescence Ⅲ energy metabolism Ⅲ imaging T he arterial wall is supplied with oxygen and nutrients by diffusion and convection from luminal blood and from vasa vasorum in the adventitia and outer media. Metabolic waste products are removed by diffusion in the opposite direction. Diffusion distances in large-and medium-sized arteries are often close to, or even exceed, the 100 to 200 m that is frequently stated as the diffusion limit for oxygen. 1-4 Based on these facts, it has been suggested that the arterial wall is predisposed to develop local energy metabolic disturbances and that this is a key factor both in the initiation and progression of atherosclerosis. 1 In atherosclerosis-prone areas, both insufficient transport 5,6 and increased consumption of metabolites 7 could contribute to local disturbances. Later in the disease process, increased diffusion distances, attributable to intimal thickening as well as a high consumption of oxygen 8 and glucose 9,10 by foam cells, could additionally aggravate energy metabolic predicaments and contribute to the development of a necrotic core. Supportive of this hypothesis, hypoxic zones have been demonstrated in situ in the normal pig arterial wall 11 as well as in vitro 12-14 and in vivo 15 in rabbit atherosclerotic plaques. However, ATP production may be maintained under hypoxic conditions via anaerobic breakdown of glucose and glycogen, but this could lead to a potentially harmful accumulation of lactate. Therefore, other aspects of energy metabolism besides the supply of oxygen need to be analyzed. To the best of our knowledge, bioluminescence imaging is the only method available that allows analysis of ATP, glucose, and lactate concentrations at the necessary spatial resolution. 16 We have recently adapted this method to measure local ATP concentrations within the arterial wall. 14 In the present study, our methodology is extended to include determinations of glucose, glycogen, and lactate. The use of bioluminescence imaging to measure glycogen concentrations is presented...