In vivo characterization of coronary plaques: novel findings from comparing greyscale and virtual histology intravascular ultrasound and near-infrared spectroscopy

Abstract

Combining NIRS with IVUS contributes to the understanding of plaque characterization in vivo. Further studies are warranted to determine whether combining NIRS and IVUS will contribute to the assessment of high-risk plaques to predict outcomes in patients with coronary artery disease.

High-Density Lipoprotein Cholesterol Level Is Associated With Fibrous Cap Thickness in Acute Coronary Syndrome

“…37 Therefore, it is difficult to estimate and quantify the amount of lipids on OCT, without spectroscopy. 38 Second, in the present study, 179 patients (69%) had thrombus. Furthermore, among them, 32 (12%) had remaining thrombi that might disturb observation of fibrous cap even after thrombectomy.…”

Characterization of coronary atherosclerosis by intravascular imaging modalities

“…In addition, LCBI above 400 was an optimal cut-off to distinguish culprit segments in patients with ST elevation myocardial infarction from coronary specimens free of lipid component. Another study elucidated better evaluation of plaque characterization under the combination of NIRS and grayscale IVUS (29). In this study analyzing 131 lesions, attenuated (P<0.0001) and echolucent plaques (P=0.008) on grayscale IVUS were associated with a larger LCBI compared to calcified and non-calcified plaques.…”

“…Echolucent plaque is generally the result of high lipid content in a fibroatheroma, but relatively smaller size of necrotic core or lipid pool compared with attenuated plaque (22,29). This plaque phenotype has been shown as a signature of culprit lesions in patients with acute myocardial infarction (30).…”

Understanding Why and When Optical Coherence Tomography Does Not Detect Vulnerable Plaques

“…However, when comparing different imaging modalities, there is rarely agreement among them about the diagnosis of individual TCFAs whether assessed in vivo or in vitro although agreement is generally worse in vivo adding to the issues about clinical vulnerable plaque detection. 4,5,[10][11][12][13][14][15][16][17][18][19][20][21] Infraredx (Burlington, MA) has developed a combined intravascular ultrasound (IVUS) and nearinfrared spectroscopic catheter that is available commercially. 22 Prototype combined IVUS and OCT catheters have been used in animal models.…”