title: Vasa vasorum imaging: a new window to the clinical detection of vulnerable atherosclerotic plaques.
abstract: Complications of vulnerable atherosclerotic plaques (rupture, luminal and mural thrombosis, intraplaque hemorrhage, rapid progression to stenosis, spasm, and so forth) lead to heart attacks and strokes. It remains difficult to identify what plaques are vulnerable to these complications. Despite recent developments such as thermography, spectroscopy, and magnetic resonance imaging, none of them is approved for clinical use. Intravascular ultrasound (IVUS), a relatively old yet widely available clinical tool for guiding intracoronary procedures, is increasingly used for characterization of atherosclerotic plaques. However, inability of IVUS in measuring plaque activity limits its value in detection of vulnerable plaques. In this review, we present new information suggesting that microbubble contrast-enhanced IVUS can measure activity and inflammation within atherosclerotic plaques by imaging vasa vasorum density. An increasing body of evidence indicates that vasa vasorum density may be a strong marker for plaque vulnerability. We suggest that a combination of structural assessment (cap thickness, lipid core, calcification, etc) and vasa vasorum density imaging by IVUS can serve as the most powerful clinically available tool for characterization of vulnerable plaques. Due to space limitations, all IVUS images and movies are posted on the website of the Ultimate IVUS Collaborative Project: http://www.ultimateivus.com.
authors.affiliation: Association for Eradication of Heart Attack-AEHA, 2472 Bolsover #439, Houston, TX 77005, USA.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Carlier
authors.forename: Ioannis A
authors.initials: IA
authors.lastname: Kakadiaris
authors.forename: Nabil
authors.initials: N
authors.lastname: Dib
authors.forename: Manolis
authors.initials: M
authors.lastname: Vavuranakis
authors.forename: Sean M
authors.initials: SM
authors.lastname: O'Malley
authors.forename: Khawar
authors.initials: K
authors.lastname: Gul
authors.forename: Craig J
authors.initials: CJ
authors.lastname: Hartley
authors.forename: Ralph
authors.initials: R
authors.lastname: Metcalfe
authors.forename: Roxana
authors.initials: R
authors.lastname: Mehran
authors.forename: Christodoulos
authors.initials: C
authors.lastname: Stefanadis
authors.forename: Erling
authors.initials: E
authors.lastname: Falk
authors.forename: Gregg
authors.initials: G
authors.lastname: Stone
authors.forename: Martin
authors.initials: M
authors.lastname: Leon
authors.forename: Morteza
authors.initials: M
authors.lastname: Naghavi
mesh_terms: D000418:Albumins / Q000008:administration & dosage; D016477:Artifacts; D003287:Contrast Media / Q000008:administration & dosage; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005466:Fluorocarbons / Q000008:administration & dosage; D006801:Humans; D007269:Injections, Intra-Arterial; D015203:Reproducibility of Results; D018084:Ultrasonography, Interventional / Q000379:methods*; D014651:Vasa Vasorum / Q000000981:diagnostic imaging*
chemical_list: D000418:Albumins; D003287:Contrast Media; C099458:FS 069; D005466:Fluorocarbons
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