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Type: Journal article
Title: Intravascular imaging of vulnerable coronary plaque: Current and future concepts
Author: Puri, R.
Worthley, M.
Nicholls, S.
Citation: Nature Reviews Cardiology, 2011; 8(3):131-139
Publisher: Nature Publishing Group
Issue Date: 2011
ISSN: 1759-5002
Statement of
Rishi Puri, Matthew I. Worthley and Stephen J. Nicholls
Abstract: Advances in coronary imaging are needed to enable the early detection of plaque segments considered to be 'vulnerable' for causing clinical events. Pathological studies have contributed to our current understanding of these vulnerable or unstable segments of plaque. Intravascular ultrasonography (IVUS) has provided insights into the morphology of atherosclerosis, the mediators of plaque progression and the factors associated with acute coronary syndrome (ACS). In addition, the demonstration of pancoronary arterial instability has highlighted that ACS involves a multifocal disease process. Various second-generation intravascular imaging technologies—employing advanced processing of ultrasound radiofrequency backscatter signals, light-based imaging, spectroscopic imaging and molecular targeting—possess inherent advantages for the identification of meaningful surrogates of plaque instability. The fusion of these imaging technologies within a single imaging catheter is likely to allow for greater synergism in image quality and early disease detection. However, natural-history studies to validate the use of these novel imaging tools for enhanced risk prediction are needed before these strategies can be incorporated into mainstream clinical practice.
Keywords: Coronary Vessels
Endothelium, Vascular
Disease Progression
Spectroscopy, Near-Infrared
Tomography, Optical Coherence
Ultrasonography, Interventional
Spectrum Analysis, Raman
Coronary Artery Disease
Acute Coronary Syndrome
Rights: © 2011 Macmillan Publishers Limited. All rights reserved
DOI: 10.1038/nrcardio.2010.210
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