Intravascular Palpography for High-Risk Vulnerable Plaque Assessment

Schaar, Johannes A.; Korte, Chris L. de; Mastik, Frits; Baldewsing, R.A.; Regar, Evelyn; Feyter, Pim de; Slager, Cornelis J.; Steen, A.F.W. van der; Serruys, Patrick W.

doi:10.1007/s00059-003-2488-6

Cited by 66 publications

(30 citation statements)

References 33 publications

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“…Other IVUS related techniques include IVUS palpography (elastography) which allows for the assessment of local mechanical tissue properties, based on the concept that soft tissues (lipid rich) will deform more than hard tissues (fibrous-calcified) when a force is applied [22]. However, this technique is unable to provide quantification of the plaque composition.…”

Section: Atheromatous Plaque Regressionmentioning

confidence: 98%

Atherosclerotic Plaque Regression: Fact or Fiction?

Shanmugam

Román-Rego

Ong

et al. 2010

Cardiovasc Drugs Ther

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Coronary artery disease is the major cause of death in the western world. The formation and rapid progression of atheromatous plaques can lead to serious cardiovascular events in patients with atherosclerosis. The better understanding, in recent years, of the mechanisms leading to atheromatous plaque growth and disruption and the availability of powerful HMG CoA-reductase inhibitors (statins) has permitted the consideration of plaque regression as a realistic therapeutic goal. This article reviews the existing evidence underpinning current therapeutic strategies aimed at achieving atherosclerotic plaque regression. In this review we also discuss imaging modalities for the assessment of plaque regression, predictors of regression and whether plaque regression is associated with a survival benefit.

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Section: Atheromatous Plaque Regressionmentioning

confidence: 98%

Atherosclerotic Plaque Regression: Fact or Fiction?

Shanmugam

Román-Rego

Ong

et al. 2010

Cardiovasc Drugs Ther

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“…It is known that standard echography has a poor sensitivity and specificity to identify the composition of plaques. However, by using more sophisticated techniques like spectral analysis [7] and elastography [8,9], the composition can be determined. In spectral analysis techniques, not only the amplitude of the reflected ultrasound signal is used, but also the frequency content of the reflected signal and the attenuation of the ultrasound signal as a function of echo depth are determined.…”

Section: Introductionmentioning

confidence: 99%

Vascular ultrasound for atherosclerosis imaging

2011

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Cardiovascular disease is a leading cause of death in the Western world. Therefore, detection and quantification of atherosclerotic disease is of paramount importance to monitor treatment and possible prevention of acute events. Vascular ultrasound is an excellent technique to assess the geometry of vessel walls and plaques. The high temporal as well as spatial resolution allows quantification of luminal area and plaque size and volume. While carotid arteries can be imaged non-invasively, scanning of coronary arteries requires invasive intravascular catheters. Both techniques have already demonstrated their clinical applicability. Using linear array technology , detection of disease as well as monitoring of pharmaceutical treatment in carotid arteries are feasible. Data acquired with intravascular ultrasound catheters have proved to be especially beneficial in understanding the development of atherosclerotic disease in coronary arteries. With the introduction of vascular elastography not only the geometry of plaques but also the risk for rupture of plaques might be identified. These so-called vulnerable plaques are frequently not flow-limiting and rupture of these plaques is responsible for the majority of cerebral and cardiac ischaemic events. Intravascular ultrasound elastography studies have demonstrated a high correlation between high strain and vulnerable plaque features, both ex vivo and in vivo. Additionally, pharmaceutical intervention could be monitored using this technique. Non-invasive vascular elastography has recently been developed for carotid applications by using compound scanning. Validation and initial clinical evaluation is currently being performed. Since abundance of vasa vasorum (VV) is correlated with vulnerable plaque development, quantification of VV might be a unique tool to even prevent this from happening. Using ultrasound contrast agents, it has been demonstrated that VV can be identified and quantified. Although far from routine clinical application, non-invasive and intravascular ultrasound VV imaging might pave the road to prevent atherosclerotic disease in an early phase. This paper reviews the conventional vascular ultrasound techniques as well as vascular ultrasound strain and vascular ultrasound VV imaging.

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“…There is however evidence that local arterial curvature of the coronary arteries may play a key role in the selective plaque formation in specific arterial sites [5]. In terms of mechanical features, a local decrease in arterial stiffness as a result of collagen and elastin breakdown is likely associated with high-risk plaques [6].…”

Section: Introductionmentioning

confidence: 99%

Insights on atherosclerosis by non-invasive assessment of wall stress and arterial morphology along the length of human coronary plaques

Katranas

Antoniadis

Kelekis

et al. 2015

Int J Cardiovasc Imaging

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Wall stress (WS) is associated with high arterial pressure and affects the localization of atherosclerotic lesions. We sought to non-invasively investigate the distribution of WS along the length of human coronary arteries and investigate its potential effect on atherosclerosis in association with vascular stiffness, local arterial curvature and plaque volume. We reconstructed three-dimensionally 28 coronary arteries from 22 subjects who had undergone coronary computed tomography angiography. Coronary arteries were divided in 2 mm-long segments. WS, vascular stiffness, plaque volume and curvature were calculated in each segment using computational fluid dynamics and morphology measurements. Plaque segments exhibited lower WS compared to their adjacent normal segments. Within plaques, WS was lower in the mid plaque portion compared to the upstream portion. Plaque volume was higher in the mid plaque portion compared to upstream and downstream portions. Low WS was associated with high curvature and both low WS and high curvature were associated with increased plaque volume. The current study demonstrates that WS and plaque volume are not uniform in the longitudinal axis of human coronary plaque. Calculation of WS could serve as a surrogate for the localization of plaque development and the identification of plaques at a more advanced stage of progression.

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Intravascular Palpography for High-Risk Vulnerable Plaque Assessment

Cited by 66 publications

References 33 publications

Atherosclerotic Plaque Regression: Fact or Fiction?

Atherosclerotic Plaque Regression: Fact or Fiction?

Vascular ultrasound for atherosclerosis imaging

Insights on atherosclerosis by non-invasive assessment of wall stress and arterial morphology along the length of human coronary plaques

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