title: The Role of Intracoronary Plaque Imaging with Intravascular Ultrasound, Optical Coherence Tomography, and Near-Infrared Spectroscopy in Patients with Coronary Artery Disease.
abstract: The development of multiple diagnostic intracoronary imaging modalities has increased our understanding of coronary atherosclerotic disease. These imaging modalities, intravascular ultrasound (IVUS), optical coherence tomography (OCT), and near-infrared spectroscopy (NIRS), have provided a method to study plaques and introduced the concept of plaque vulnerability. They are being increasingly used for percutaneous coronary intervention (PCI) optimization and are invaluable tools in research studying the pathophysiology of acute coronary syndrome (ACS), in-stent thrombosis and in-stent restenosis. IVUS has the ability to visualize the intracoronary lumen and the vessel wall and can be used to detect early atherosclerotic disease even in the setting of positive arterial remodeling. Studies supporting the use of IVUS to optimize stent deployment and apposition have shown a significant reduction in cardiovascular events. OCT provides even higher resolution imaging and near microscopic detail of plaques, restenoses, and thromboses; thus, it can identify the etiology of ACS. Ongoing trials are evaluating the role of OCT in PCI and using OCT to study stent endothelialization and neointimal proliferation. NIRS is a modality capable of localizing and quantifying lipid core burden. It is usually combined with IVUS and is used to characterize plaque composition. The benefits of NIRS in the setting of ACS have been limited to case reports and series. The utilization of all these intracoronary imaging modalities will continue to expand as their indications for clinical use and research grow. Studies to support their use for PCI optimization resulting in improved outcomes with potential to prevent downstream events are ongoing.
authors.affiliation: Department of Internal Medicine, Division of Cardiology, Baylor College of Medicine, One Baylor Plaza MS: BCM 620, Houston, TX, 77030, USA.
authors.forename: Vu
authors.initials: V
authors.lastname: Hoang
authors.affiliation: Department of Internal Medicine, Division of Cardiology, Baylor College of Medicine, One Baylor Plaza MS: BCM 620, Houston, TX, 77030, USA.
authors.forename: Jill
authors.initials: J
authors.lastname: Grounds
authors.affiliation: Department of Internal Medicine, Division of Cardiology, Baylor College of Medicine, One Baylor Plaza MS: BCM 620, Houston, TX, 77030, USA.
authors.forename: Don
authors.initials: D
authors.lastname: Pham
authors.affiliation: Department of Internal Medicine, Michael E. DeBakey Veterans Affairs Medical Center Health Services Research and Development and Section of Cardiology, Baylor College of Medicine, Houston, USA.
authors.forename: Salim
authors.initials: S
authors.lastname: Virani
authors.affiliation: Department of Internal Medicine, Division of Cardiology, Baylor College of Medicine, One Baylor Plaza MS: BCM 620, Houston, TX, 77030, USA.
authors.forename: Ihab
authors.initials: I
authors.lastname: Hamzeh
authors.affiliation: Department of Pediatrics, Division of Pediatric Cardiology, Texas Childrens Hospital and Baylor College of Medicine, Houston, TX, USA.
authors.forename: Athar Mahmood
authors.initials: AM
authors.lastname: Qureshi
authors.affiliation: Department of Internal Medicine, Division of Cardiology, Baylor College of Medicine, One Baylor Plaza MS: BCM 620, Houston, TX, 77030, USA.
authors.forename: Nasser
authors.initials: N
authors.lastname: Lakkis
authors.affiliation: Department of Internal Medicine, Division of Cardiology, Baylor College of Medicine, One Baylor Plaza MS: BCM 620, Houston, TX, 77030, USA. mahboob.alam@bcm.edu.
authors.forename: Mahboob
authors.initials: M
authors.lastname: Alam
mesh_terms: D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D062645:Percutaneous Coronary Intervention; D058226:Plaque, Atherosclerotic / Q000150:complications / Q000000981:diagnostic imaging*; D019265:Spectroscopy, Near-Infrared; D015607:Stents; D041623:Tomography, Optical Coherence; D018084:Ultrasonography, Interventional
keywords: Coronary artery disease; Intravascular ultrasound; Near-infrared spectroscopy; Optical coherence tomography