What Is Hidden Behind Yellow Pixels: from Pathology to Intravascular Imaging of Atherosclerotic Plaque

Curr Atheroscler Rep. 2022 Feb;24(2):97-108. doi: 10.1007/s11883-022-00990-3. Epub 2022 Feb 2.

Abstract

Purpose of review: Intravascular imaging systems can identify lipid-rich and vulnerable plaques and help in treatment guidance. The comparability of different intracoronary imaging methods remains unclear. In this paper, we review atherosclerotic plaque pathology, plaque-stabilising effects of different lipid-lowering therapies and usage of intravascular imaging modalities. We present the results of our study in which we evaluated the correlation of the intravascular ultrasound iMAP system (iMAP-IVUS) and near-infrared spectroscopy (NIRS) in the diagnosis of vulnerable coronary plaques.

Recent findings: Lipids have an essential contribution to plaque evolution and vulnerability. Increase in plaque vulnerability alone even without increase in plaque burden defines progression of atherosclerosis. Lipidic tissue has a significant diagnostic value in patient risk stratification and can serve as a treatment target. Different vulnerable plaque parameters can be visualised with iMAP-IVUS and NIRS. Intravascular imaging systems can differ with regard to their sensitivity, specificity and limitations. Lipid-lowering therapy is crucial in plaque stabilisation.

Keywords: Atherosclerotic plaque; Coronary artery disease; Intravascular imaging; NIRS; iMAP-IVUS.

Publication types

  • Review

MeSH terms

  • Coronary Artery Disease* / diagnostic imaging
  • Coronary Vessels / diagnostic imaging
  • Coronary Vessels / pathology
  • Humans
  • Lipids
  • Plaque, Atherosclerotic* / diagnostic imaging
  • Spectroscopy, Near-Infrared / methods
  • Ultrasonography, Interventional / methods

Substances

  • Lipids