The Year in Intracoronary Imaging

Cholesterol Efflux and Atheroprotection

“…The ideal invasive tool for characterization of vascular plaque would provide a complete roadmap of atherosclerotic burden throughout the coronary tree and provide per plaque lesion specific data characterizing the architecture, composition and dynamic biology of each plaque. Specific parameters should include: (1) extent of luminal stenosis; (2) lesion length; (3) coronary blood flow reserve through any given narrowing; (4) intramural plaque architecture including atheroma burden, eccentricity, and local vascular remodeling; (5) plaque composition, specifically lipid content; (6) fibrous cap thickness; and (7) presence of inflammation (143–145). …”

“…Structural changes in the vessel wall include overall measures of vessel wall thickness to specific measures of plaque size, composition and inflammatory burden (143–145). The composition and the inflammatory activity of the atheromatous plaque have important implications for clinical events (154).…”

Hybrid intravascular ultrasound and optical coherence tomography catheter for imaging of coronary atherosclerosis

“…Coronary angiography has strong limitations in visualizing local plaque morphology and interventional results . Advances in intracoronary imaging technologies provide adjunctive imaging support to coronary angiography, and improvements in these technologies may address important clinical and research needs in CAD management . Effective in vivo intravascular imaging is especially important in improving our current understanding of atherosclerotic plaque progression, which may lead to better understanding and management of plaque vulnerability, sudden occlusive thrombosis, and major adverse cardiac events (MACE) in CAD .…”

“…In recognition of the multifactorial nature of CAD and coronary events, no single imaging modality has proven to be adequately comprehensive for the goals outlined above. It has been postulated that using a combination of complementary imaging tools may provide new insights and advancements into the management of CAD .…”

“…Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) have synergistic advantages . IVUS is a widely used clinical imaging tool and has provided important information on plaque progression, as well as the effects of several pharmaceutical agents and devices .…”